Connecticut Blue Star Mothers

Blue Star Mothers of America, Inc.

<DIR> <DIR>

Organized 1942 – Congressionally Chartered 1960 www.bluestarmothers.org

× Membership Application × Transfer Application × JANUARY 2009 through DECEMBER 2009 ×

</DIR></DIR></DIR></DIR></DIR></DIR></DIR></DIR></DIR></DIR></DIR></DIR></DIR></DIR></DIR></DIR></DIR></DIR></DIR></DIR></DIR></DIR></DIR></DIR>

FOR THOSE JOINING CONNECTICUT BLUE STAR MOTHERS -- CT CHAPTE ONE:

Please send application & dues to: Connecticut Blue Star Mothers PO Box 91 Plymouth, CT 06782

Attention: Donna Sanford, Membership Officer

Please make checks payable to: Connecticut Blue Star Mothers - CT Chapter One

If not joining Connecticut Blue Star Mothers -- CT Chapter One: Check www.bluestarmothers.org or email firstvp@bluestarmothers.org for contact information for a chapter in your area. Membership applications/dues can be submitted directly to the chapter you join, check made payable to: Blue Star Mothers of America, Inc. Or they can be mailed to: Blue Star Mothers of America, Pat Soler Financial Sect, 5533 Terra Granada 1A, Walnut Creek, CA 94595

Annual Membership Fee: $20 Note: Associate Members and Dads do not pay fees.

Please check one of the following:

Membership: I am a New Member:___

I am a Transfer Member ___ From Chapter #, City and State_______________________________

I am a member renewing for year:________

Please check one of the following:

I am a: ___ Mother ____Step Mother____Associate ___Dad ~ I am a Gold Star Mother ____yes ___no

Please print Chapter Name, Number and Location: Connecticut Blue Star Mothers CT Chapter One

Applicants Full Name: __________________________________________________

Address: (city, state & zip), (WE MUST HAVE COMPLETE INFO) _____________________________________________________________________________________________________________________________________________________________________________

Email: _________________________________________________________

Home Phone:(REQUIRED) ____________________________ cell (optional) ____________________

Birthdate: __________________________

Please fill out the following for each military/veteran child. Use reverse side if necessary:

Name	M/F	Branch/Veteran

LOYALTY OATH: I do solemnly swear that I am not a Communist, Fascist, or Terrorist. I do not advocate nor am I a member of any organization that advocates the overthrow of the government of the United States by force or violence or other unconstitutional means or seeking by force or violence to deny any person their rights under the Constitution of the United States.

I do further swear that I will not so advocate nor will I become a member of such an organization during the period I am a member of the Blue Star Mothers of America, Inc. I will support and defend the Constitution of the United States against all enemies foreign or domestic; that I will bear true faith and allegiance to the same that I sign this oath freely, without any mental reservation or purpose of evasion, so help me God.

Signature: __________________________________________Date:_______________________________

For Administration Only: Date application received _________ Received by: _________________

Paid: by check #. ______ cash money order # _______________ Amount: ______________

Membership card: given mailed Date: _________ Date deposited into account: ________________________