Membership Application

SAMS is a tax exempt, non-profit corporation chartered in North Carolina; dues and contributions are deductible under IRS Code Section 501(c)(19) pertaining to organizations of War Veterans of the United States.  [EIN 56-1356844]

MEMBERSHIP APPLICATION
(Revised 20060201; all others obsolete)

Please fill in ALL blanks applicable to you; print carefully, no abbreviations please. Give inclusive dates of one qualifying period of active or Reserve service. If you are currently serving give the starting date and indicate to "present." If you have previously served on active duty please attach a photocopy of your DD214 ("Certificate of Release or Discharge from Active Duty.") If currently serving on active duty or in the reserve, attach a photocopy of front and back sides of your ID card. If no DD214 is available or you are no longer serving or you are an ROTC cadet, attach any official orders or published document evidencing that fact.

A. SCOTTISH BACKGROUND:

[  ] I am of Scottish birth (Place: _________________________________);
[  ] I am a member in good standing of a Scottish heritage society which requires Scottish ancestry as a condition of membership.
Society Name: ____________________________ Location: _____________________. (Attach copy of card);
[  ] Scots or Scotch-Irish descent; my surname is _________________.  The name, point of origin and relationship of my
ancestor is: ________________________________________________________________________________
[  ] If not of Scottish descent, reason(s) for requesting membership (i.e. marriage to a Scot, Commonwealth military service, etc.);

B: MILITARY SERVICE:

[  ] Past extended active duty in US Armed Forces:  Service: _________________; From ___________to______________.
[  ] Present extended active duty in US Armed Forces: Service: _______________; Start date (BPED): _______; Grade: _____.
[  ] Service in Reserves, National Guard or senior college ROTC: Service: ____________; From __________to____________.
[  ] Active US service anywhere during one or more war periods listed overleaf including Grenada, Lebanon, Persian Gulf or other campaign qualifying for an "I was there" ribbon; explain: _________________________________________________.
[  ] British Commonwealth Service:  Unit/Service: ___________________________; Date(s): ________________________.
[  ] No military service (NMS).  Only approved by staff for exceptional reasons: Your reason: _________________________.

I declare that my statements contained herein are true to the best of my knowledge and belief and that if admitted to membership in SAMS, I will abide by the Society's Charter and By-Laws and those of any SAMS Post I may subsequently join.
     
Application Fee* $25.00 *The Application Fee covers the cost of printing and mailing of membership certificate,
Voluntary contribution? $______ wallet card, by-laws and rules. **Our Fiscal Year is 1 JUL - 30 JUN, but if you join
TOTAL (min $25.00): $______ between 1 APR and 30 JUN, you will be credited for 15 months.


_______________________
(Date of Application)


________________________________________
(Printed Full Name)


_______________________________
(Signature)

(     )_________________
Home Phone
(     )_________________
Office Phone
(     )___________________
Other Phone
____________________________
E-Mail Name

Clan affiliation:_______________________________
Street or PO Box:_______________________________________
Occupation:__________________________________ City, State: ____________________________________________
Spouse's Name: _______________________________ Zip, Country: __________________________________________
Hobbies of Interest (i.e. Piper, Drummer, Genealogist, Historian): ________________________________________________
 

Make checks payable to S.A.M.S. and mail with supporting documents to:
Scottish-American Military Society (S.A.M.S.), c/o Alan R. Burke , Adjutant General
PO Box 27 , Woodleaf, NC 27054 ; Phone (336) 682-4284
E-Mail:  samsnationalag@yahoo.com