Montford Point Marine Association, Inc Membership Application Membership is open to all Veterans and Active Duty member of all branches of the Armed Forces, regardless of race, creed, or national origin. Current Membership fees: Annual $30.00 (include local fees)  / Life: $150.00 - $300.00 If you would like to become a member please print the membership application and mail your payment to MPMA 10, P O Box 928, Camp Lejeune, NC 28541. Last Name:____________________ First Name:__________________ MI:______ Address:____________________________________________________________ City:________________________ State:______________ Zip Code: __________ Email Address: ________________________________________________________ Home Phone: ______________ Work Phone: _____________ DOB: ___________ Branch of Service:_________________ Active [__] Retire [__] Veteran [__] Rank: _______________________ Service Id#: __________________________ Membership Type: Life [__] Partial Life [__] Annual [__] Lifetime membership fees are base by age the current fees are as follow: Up to age 29 cost is $300.00, 30-39 is $275.00. 40-59 is $200.00, 60 and up $ 150.00 I certify that I have honorably served in the United States Armed Forces for more than 90 days, and that I received an Honorable discharge at the time of my separation. By signature of this application, I agree to provide proof of my discharge upon request. Applicant Signature: __________________________ Date: _________________   Click here on the application button for a fillable/ printable version of this application.    Adobe Reader is require click on icon to download Adobe reader.