Full Name:  Rank:  

Date of Birth:   Spouse Name:    

Street:  City:  State:  Zip:   

Home Phone:  Cell Phone:   

Total Time of Service:  Time Served with the 193rd:   

Last Squadron Assigned:   

193rd Status

Email address: Use personal email address, not military

Type Membership

Annual Membership $15.00. Lifetime Membership (to determine your dues, subtract your age from 100 and
multiply that by three) Membership shall run from 1 January to 31 December. Dues paid after 1 October will be applied to the next year.:  Type Membership

I am on a free membership

Method of Payment

If Check please include check number and Mail payment to 193rd SOW Association 81 Constellation Court #14 Middletown Pa 17057:   

You can sign by accepting the way the system presents your name or actually sign it with your mouse or finger on mobile devices.

When signed online you can download the PDF for your records.

Leave this empty:

Please Confirm full name and signature.

Change fonts

• Draw Signature
  
• Type In Signature
  

Draw your signature with your mouse, tablet or smartphone Clear

I agree that I am and I agree this is a legal representation of my signature for all purposes just the same as a pen-and-paper signature

Insert Signature

I agree that I am and I understand this is a legal representation of my signature

Adopt & Sign

193 SOW Association https://www.193sow.org

Signature Certificate

Document name: 193rd SOW Association Membership Application

Unique Document ID: 6deba766d786e63c9d33f339cb2a63a86ef4c93c

Build. Track. Sign Contracts.

Timestamp	Audit
2015-04-23 15:53:53 BST	193rd SOW Association Membership Application Uploaded by Michael Kelly - mike.kelly@193sow.org IP 73.64.13.143

This audit trail report provides a detailed record of the online activity and events recorded for this contract.

http://www.193sow.org/

Audit Trail Serial# add85cfeec54e88afe7f6c31bea3f167