MEMBERSHIP APPLICATION Membership in the 11ACVVC is open to all who were attached or served with the 11th Armored Cavalry Regiment during the Viet Nam War. Please complete this form so that we may process your application.

      NAME:   

      Address:      
      City:    State/Province:      ZIP Code:   
      Country:    

      Use "Comments" below if address above is Unit Address 

      Phone:                           Email:  
      UNIT (TRP/SQD):          

      Use "Comments" below to list additional units you were assigned to in the 11th ACR 

      When?(MO/YR to MO/YR):  
      SSAN or SSN:                    

      Type Membership
      Update  New   Renewal  Life ($100)  Annual ($15) 
      Authorize release of address/phone number to other troopers who served with 11thACR? 

      Comments:

      If this is a renewal, what is your membership number?

      To Pay by Credit please fill out the information below. 

      Name on Credit Card

      Credit Card Number

      Type of Card Visa or MasterCard

      Expiration date of card month/year

      Signature Required

      Or you may pay by check or money order.


    • Print out this form, along with proof of your service in the 11th ACR in Viet Nam and/or Cambodia, and mail, along with your check/money order payable to "The 11ACVVC" to:
       
    • Ollie Pickral
      571 Ditchley Road
      Kilmarnock, VA 22482