Regular or Associate Member

$10 Annual Donation or

$25 for 3 years.

Lifetime Member or Corporate

$50 Donation

Lifetime Veterans Organization

$50 Donation

CCVC Membership Application

Please submit proof of military service or membership in a military organization (DD 214, VFW, American Legion, etc.).

1. Fill out this form online    2. Print it    3. Mail to:

Citrus County Veterans Coalition, P.O. Box 851, Inverness, FL 34451

NOTE:  Be sure to include a self-addressed, stamped envelope in order to receive your membership card.

First Name

Last Name

ADDRESS

CITY

STATE

ZIP CODE

PHONE NUMBER

BRANCH OF SERVICE

DATES OF SERVICE

VETERANS GROUP AFFILIATIONS

EMAIL

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