Marine's Memorial Association

Membership Application

Please fill out the form below for an annual Veteran or Currently Serving membership. Asterisk (*) denotes required field. If you have questions about this application or would like to fill out a PDF version, email Member@MarinesMemorial.org.

Click HERE to become a lifetime Benefactor member of the Marines’ Memorial.

Military Status

Additional Donation:

Service Branch

Estimated Date You Entered US Military Service

Estimated End of Active Service in US Armed Forces (or Date on CAC)

If you served during any of the War Periods below, please select those dates (choose 1)

What was your last duty assignment/command while serving OR what is your current assignment?

Current Rank or Highest Rank Attained

Characterization of Service

Contact Information

Member First Name:

Member Middle Name:

Member Last Name:

Member Street 1:

Member City:

Member State/Province:

Member ZIP/Postal code:

Email Address:

Member Phone Number:

Birthdate

How did you hear about us?

Referring Member or Explain "Other" response above

Spouse Cardholder

Spouse First Name

Spouse Last Name

Spouse Email

Spouse Relationship

Number of Additional Cardholders? (Additional Cardholders are $50 each)

Additional Cardholder 1

First Name

Last Name

Relationship

I understand that cardholders on my membership must be at least 21 years old.

Yes

Additional Cardholder 2

First Name

Last Name

Relationship

I understand that cardholders on my membership must be at least 21 years old.

Yes

Additional Cardholder 3

First Name

Last Name

Relationship

I understand that cardholders on my membership must be at least 21 years old.

Yes

Billing Information

Specifies to use the donor information as the billing information

Title:

First Name:

Middle Name:

Last Name:

Suffix:

Street 1:

Street 2:

City:

State/Province:

ZIP/Postal Code:

Country:

Yes, I would like to receive communication from this organization.

Remember Me

Payment Information

Credit Card Information:

Credit Card Type:

Credit Card Number:

Expiration Date:Select month of credit card Select Expiration Year

CVV Number: What is this?

Key Words

Menu

Membership Application

Contact Information

Spouse Cardholder

Additional Cardholder 1

Additional Cardholder 2

Additional Cardholder 3

Billing Information

Payment Information

Credit Card Information:

Survey

Marines' Memorial Association