First Battalion, Fourth Marines Association

Membership Application



Name_______________________________Phone #(Hm)_______________(Wk)__________________




Address_____________________________ City______________ State______ Zip Code___________


Rank______ Active/Discharged/Retired (A/D/R)_______ Period of Service(From)__________(To)___________


Personal Awards/Decorations:____________________________________

(Purple Heart, Etc.)





Period of Service with 1st Battalion, 4th Marines: (From)_______________(To)___________________


Unit(s) assigned to while with 1st Battalion, 4th Marines: Company_________ Platoon____________


Applying For Annual______Life______Membership Amount_________

Copy of DD 214/DD215 or Discharge Enclosed

YES_______ NO_______


How Did You Find Out About The Association? Friends Leatherneck___ VFW___MOPH___

WWW Internet___ MC Gazette___ DAV____ CALTRAP___ VVA___ American Legion___

Other(Please Specify)_______________________


Dues Information

Note: Print this form out and mail in with your check.

Annual Member - $20.00

Life Member: Under 55 - $200.00
55 to 64 - $150.00
65 and over - $75.00

Make Checks payable to:

1st Battalion, 4th Marines Association

706 Harmon St

Urbana, Il. 61801

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Our National BYLAW require that if Discharged from Military, a copy of your DD214 /DD215 or copy of Military Discharge must be presented. 

If you do not have any of these documents, send Application and Membership Committee will contact you.