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10 Year Veteran Membership Subscription

Please enter your information on the form below to process your subscription for 10 Year Veteran Membership.

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Personal Details

First Name *

Last Name *

Identity Number *

Date of Birth *

Force Number

Mobile Number *

Home Town *

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Country *

Province *

Connection to Battle Group Juliet/61 Mech Battalion

Year(s) in which you served at the unit *

Exercises

Oefening Vlakhaas

Oefening Sweepslag

Oefening Sombre

Corps *

Role(s) in the unit *

Rank(s) at the time *

Name of your direct commander *

Name of your subunit commander *

Name of unit commander at your time of service *

Name of referent who can confirm this information *

E-mail/mobile number of referent *

I subscribe to the objectives of the 61 Mech Veterans Association *

Yes

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Expiration Date*

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Card Holder Name*

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