International Conference of War Veteran Ministers
Membership Application Form
Please print out and mail to ICWVM, 101 Walker St., Apt B1, Newtonville, MA 02160-1552
Personal
- Name:
- Address:
- Home Phone #:
- Work Phone #:
- Cell Phone or Pager #:
- Email address:
- Date of birth
- Religion/Denomination
- Date ordained, if applicable
- Church / Work Affiliation and Title:
- Branch of Service
- War served in, e.g. Vietnam, Iraq, other
- Dates of War Service
- Rank
- Units served with
- Geographical Area of War Service
- Badges and Awards
- Spouse's Name
- Date of Marriage
- Names of children
- Signature
- Date: