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Regular
(Veteran & Retired) US Marine, US Navy, US Army, US Air Force, US Coast Guard, Merchant Marine (wartime) Annual donation: $100.00 ($10.00 initiation fee)

Currently Serving
All Services $35.00 (Rates remain the same until personnel departs Active/Reserve status, then normal member rates apply)

Benefactor
Donation: $2,500. Open to all Veterans. No annual contribution required. Special Membership Card; engraved plaque; room upgrade at no additional cost on availability basis upon check-in; advance special event reservations; 15% discount in food & beverage in the Leatherneck Restaurant and Memorabilia purchases; your children over 21 will be issued Guest Cards at no cost.

Membership Information:

First Name, MI, Last Name: ________________________________________________

Branch of Service: USMC USN USA USAF USCG

Military Status: Former Retired Reserve

Highest/Current Rank: ___________________________________________________

Birth Date: ____ / ____ /19_____

Email: ___________________________________ @ _____________________________

Address: ________________________________________________________________

City: ___________________________________ State: _________ Zip: ____________

Home Phone: _________________________ Fax: _____________________________

I certify that I served on Active Duty in the U.S. Armed Forces
from __________ to __________

How did hear about us?

Advertisement or News Article Visit to the Club or Theatre

Site Presentation Member/Family/Friend

Other ___________________

Family Members:

Your spouse, children over 21 years (who are ineligible for membership by themselves) and parents are eligible for Guest Cards. Spouse card is complimentary; all others are $20; annually, per Guest Card. Please list names, relations and ages of those for whom you would like to add. In-laws are ineligible.

Last Name First Name MI Relationship Age Amount
___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

Processing your membership application:

In addition to the completion of the above information please attach the following:

• Photocopy of Military Verification:
  DD214 Form or Honorable Discharge Paper
  Retired I.D. card or Active Duty/Reserve I.D.
  
  *Note: If you cannot locate your verification or know that it has been lost, you can obtain a copy by writing:
  National Military Personnel Records Center
  9700 Page Blvd. St. Louis, Missouri 63132

• Appropriate Donation

Circle Payment Type:

MC, VISA, AMEX, Diners Club, personal check or other: ________________

Total Amount Due $ ____________

Credit Card # ____________________________________ Exp. Date ____________

Signature _________________________________________ Date _______________

Signature of Applicant ___________________________________ Date ________________

Referred by ___________________________________________ Member # ___________

Contact Information:

Membership Department: 415.673.6672 x223
Membership Fax: 415.563.5820
E-mail: Member@marineclub.com
Web Site: www.marineclub.com
Toll Free Line: 800.5.MARINE

Welcome Aboard!

Rev12June06