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|is a 501 (c) (3) non-profit organization gay, lesbian, bisexual and transgendered active duty, reserve and veteran service members, challenging the DOD's policy of discrimination with regard to sexual orientation, whether actual or perceived. Membership in AVER is open to all who support the goals of the organization and does not suggest or imply sexual orientation of any of its members. All membership information is strictly confidential, as directed by the National Constitution, within the limits of applicable laws.|
|Initial Application____||Renewal _____||Update only____|
Service Background Proof of
service: DD214, or Mil. ID;. Branch of Service and Dates are mandatory.
Branch of Service: _______________________ Active or Reserve Now? Yes _____ No _____
Dates of Service: From: ______ / ______ / ______To: ______ / ______ / ______
Highest Rank Held (circle one): E 1 2 3 4 5 6 7 8 9 W 1 2 3 4 5 O 1 2 3 4 5 6 7 8 9
Please list additional service information including honors, medals, citations, letters of commendation and appreciation from your service career on the back of this form.
|Legal Assistance||Veterans Issues (HIV,etc)||Press Contact / Releases|
|Legal Observer||ROTC Issues||Local Area Contact Person|
|Fund Raising||Public Speaking||Education & Awareness|
|Membership (Includes National and Chapter if available)||$35.00||Please Make Payable to:|
|Corporate / Organizational Sponsor||$50.00||AVERNY|
|Life Member (One time payment)||$500.00||
PO Box 150160
Kew Gardens, NY 11415
|All Memberships expire on 30 September. NEW Memberships effective after 1 March will expire on 30 September of the following year.|
|Chapter Use Only: Rec'd: ______ / ______ / ______ National Use Only: Rec'd: ______ / ______ / ______|
AVER Membership Form 6/2002, AVERNY modified 0803. All previous versions obsolete and will be returned for correction.