ENROLLMENT & UPDATE FORM:

                          VIETNAM VETERANS of BRAVO BATTERY
                  1stBn 12th MARINE Regiment (April 1965-October 1969)
        
Please copy this page & send with optional $10.00 Dues Check Payable to:  

Mike Beckdolt
1500 Mesa Verde Dr E. A-126
Costa Mesa Ca 92626

NAME: 

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D.O.B.:

DATES w/ Bravo

GUN:

SECTION: (FDC, COMM, MT, ETC)

If FORWARD OBSERVER:  Company assigned to:

HONORS (Silver/Bronze Stars, Purple Heart, etc. and Operation(s) where awarded if known)

SPOUSE:

COMMENTS:

  

  

  



Or snail mail to Mike at:
Mike Beckdolt
1500 Mesa Verde Dr E. A-126
Costa Mesa Ca 92626