MEMBERSHIP DATA SHEET (Last Revision Mar 2004*)
To apply, renew, or change membership into the San Antonio Chapter (SAC-TAI) and
National Organization of Tuskegee Airmen Inc. (R), complete and submit this form or
TAI Form 2 with your membership payment of $80.00 ($60.00 for active duty Company
Grade Officers O1-O3; $45.00 for active duty enlisted; $30.00 life members, youth, and
students) annually to:
SAC-TAI, P.O. Box 264, Randolph AFB TX 78148-0264 or to any member of the SAC-TAI
executive committee.
New........ Renew........ Change Record Date: _______________
PLEASE PRINT:
Title _____First Name _____________________ MI ______
Last ________________________________ Jr.,Sr. ______
Address Line 1 ___________________________________
Address Line 2 ___________________________________
City ________________________ State ______ Zip + Four_________
Membership Class (circle one): Regular Patron Student Junior Honorary Life
Membership Class (circle one)
A –Tuskegee AACP/unit (TE)
B – spouse/ descendant of member A (TH)
C – member of TAI other than A or B (TA)
To apply, renew, or change membership into the San Antonio Chapter (SAC-TAI) and
National Organization of Tuskegee Airmen Inc. (R), complete and submit this form or
TAI Form 2 with your membership payment of $80.00 ($60.00 for active duty Company
Grade Officers O1-O3; $45.00 for active duty enlisted; $30.00 life members, youth, and
students) annually to:
SAC-TAI, P.O. Box 264, Randolph AFB TX 78148-0264 or to any member of the SAC-TAI
executive committee.
New........ Renew........ Change Record Date: _______________
PLEASE PRINT:
Title _____First Name _____________________ MI ______
Last ________________________________ Jr.,Sr. ______
Address Line 1 ___________________________________
Address Line 2 ___________________________________
City ________________________ State ______ Zip + Four_________
Membership Class (circle one): Regular Patron Student Junior Honorary Life
Membership Class (circle one)
A –Tuskegee AACP/unit (TE)
B – spouse/ descendant of member A (TH)
C – member of TAI other than A or B (TA)
Circle as appropriate
Status:
Officer Enlisted
Civilian No Military
Service:
Air Force
Army
Coast Guard
Marines
Navy
Active Duty
Reserve
National Guard
Separated
Retired
Status:
Officer Enlisted
Civilian No Military
Service:
Air Force
Army
Coast Guard
Marines
Navy
Active Duty
Reserve
National Guard
Separated
Retired
Home Phone _____________________
Work Phone _____________________
FAX Phone ______________________
Other (Mobile) ____________________
E-Mail Address _________________________________
E-Mail Address 2 ________________________________
Work Phone _____________________
FAX Phone ______________________
Other (Mobile) ____________________
E-Mail Address _________________________________
E-Mail Address 2 ________________________________
Highest Rank Held _______________
Mil/Civ Pay Grade _______________
Years of Service ________________
Mil/Civ Pay Grade _______________
Years of Service ________________
I agree to abide by the Constitution and Bylaws of the San Antonio Chapter and Tuskegee Airmen, Inc.
Signature ______________________________________
Sponsor ______________________________________
Signature ______________________________________
Sponsor ______________________________________
Chapter Use:
Chapter: San Antonio
Region: Central
Received at Chapter (Date): ________________ Received at Chapter ($): ______________
Received at Chapter (Sign) ____________________________________________________
TAI Form 2 Completed (Date/Sign): _____________________________________________
Chapter: San Antonio
Region: Central
Received at Chapter (Date): ________________ Received at Chapter ($): ______________
Received at Chapter (Sign) ____________________________________________________
TAI Form 2 Completed (Date/Sign): _____________________________________________
| The San Antonio Chapter of Tuskegee Airmen, Inc. is a non-profit entity under Section 501(c)(3) of the Internal Revenue Code of 1986 “To be renowned for what we do and respected for how well we do it.” |