Membership Application for the Second Battalion, 4th Marines Association, Inc.   (A Not-for-Profit Association)

  This information will be included in the Published Roster on the 2/4 web page; only names, dates of service and unit information will be published.  For security, your home, work information, including phone numbers and email address…will not be listed.   This information will only be made available through the Roster Manager of the Association unless you initial here for this information to be passed out upon request________.  We ask for a nickname if applicable because it does make it easier for those of us that are memory challenged, some of us can only remember a person by “Juicy” or “Magnet Ass” or even worse.

  Name: First ______________________________ MI: ______Last: ______________________________

  Phone #: (_____)_____--_____________________ Work #: (____)______--_____________________

  Email address: ______________________________Nickname known by: __________________________

  Address:_______________________________________________________________________________

  City:___________________________________ State:__________ Zip Code + 4: ____________--_______

  Rank: current/separation ___________________ Present status:  Separated ______ Active Duty ______

  Period of Service with 2/4: (From)____/____/____     (To)____/____/____

  Unit assigned during tour with 2/4 (inc. Platoon & Co.): __________________________________________

  Personal Awards/Decorations:_______________________________________________________________

_________________________________________________________________________________________

*****Optional Information*****

Name of Spouse or Significant other :__________________________________________________________

Children's Names: _________________________________________________________________________

High School: ________________________________ College: ____________________________ Degree ___

Current Occupation:________________________________________________________________________

Employer:________________________________________________________________________________

Hobbies/Interests:__________________________________________________________________________
(Books, Articles, etc)________________________________________________________________________

(Civil Service) _____________________________________________________________________________

(Notable Feats) ____________________________________________________________________________

 If there are circumstances that you cannot afford the dues or if you wish to support others by donating to our dues fund please contact the current Association President at: President@2ndbn4thmarine.com 

*****Dues Information*****

Note: Print this form and mail it with your check.

No information will be released to anyone outside the Association under any circumstances.

  Life Membership dues can now be paid in 3 installments over a time period not to exceed

 9 (nine) consecutive calendar months.

  Annual Membership runs from July 1st through June 30th

 It will be all the members' reasonability to schedule the payments, as the Association lacks the funds and manpower to send out past due notices.  If you fail to complete payment of the life membership dues, any sums paid towards it will be converted and credited as Annual Membership dues.

Make Checks or Money Orders payable to 2/4 Association Treasurer 

If you are currently serving on Active Duty just state "ACTIVE DUTY" on the application

Mail to: 

Second Battalion, 4th Marines Association, Inc.

PO Box 6511

Concord NC 28027

AssocRosters@www.2ndbn4thmarines.com