KOREA VETERANS ASSOCIATION OF CANADA 
L'ASSOCIATION CANADIENNE DES VÉTÉRANS DE LA CORÉE

KVA Unit #               Unit Name                                         Location                                                    

NAME                                                                                                                                                                                  Surname                                                   Given Names

ADDRESS                                                                                                                                                

CITY                                                 PROV.                        POSTAL CODE                                        

TELEPHONE (        )                      FAX(        )                             E-MAIL                                             

UNIT IN KOREA                                                             SERVICE #                                       

WHAT YEAR(S) WERE YOU IN KOREA?                                                                                         

MEDALS & DECORATIONS AWARDED                                                                                         

                                                                                                                                                                      

NEXT OF KIN                                                         RELATIONSHIP                                                   

ADDRESS                                                                                                                                                       

As an applicant for membership in the Korea Veterans Association of Canada I hereby agree to abide by the rules & regulations as set forth by the Association from time to time and will to the best of my ability support all activities conducted by members of the unit and will strive to assist our Korea Veterans in every possible way.

If you are accepted as a member would you be willing to serve on Committees or Executive?

Yes □ No □ Maybe □

SIGNATURE OF APPLICANT                                                             DATE                                       

A cheque in the amount of the unit’s annual dues should accompany your application. A copy of this form should be forwarded to your Regional & National Membership Chairmen when reporting the new member.