Association Membership Registration / Annual Dues $25.00:

	Names: ( You / Spouse / Children / Nicknames / Etc. ): _____________________________

	Dues Paid:  $  _____________      	      		For Year: __________________

	Mailing Address: ___________________________________________________________________

	Telephone: _________________ Fax Number / Email / URL : ____________________________

	VITAL STATISTICS:

	Date(s) Joined VR-21 and/or VRC-50: _______________

	Date(s) Left the Squadron: _____________

	Stationed at: _________________________________Highest Rate or Rank: _______________

	Primary Job(s) (i.e. Pilot; Maint; Admin; Aircrew; Type Acft):

	____________________________________________________________________________________

	What can you contribute to this newsletter?  Photos? Rememberances? Etc.: 

	____________________________________________________________________________________

	Mail completed form to:                VRC-50 Association, Inc.
                                               Registration / Locator Department
                                               P.O. Box 248
                                               Hector, Illinios  62248-0248     

	Telephone (President) : 1 - 919 - 510 - 4293
	Telephone (Locator) :   1 - 618 - 473 - 3088