WOMEN VETERANS OF NEW MEXICO NEW APPLICATION FORM

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Please provide the following information.

Please Note: We only use this information to reach out to you for volunteer opportunities, membership events, newsletter communication, and for supportive services. We will never share your private information with anyone outside of our organization. Your contact information (phone number, address, email address, and name) will be shared with our board members and volunteers in an effort to reach you about an opportunity to connect other women veterans.

Email *

Today's Date *

YYYY

First Name *

Last Name *

Street Address *

City *

State *

Zip Code *

Phone number (Include Area Code) *

Alternate Phone (Include Area Code)

Date of Birth *

YYYY

Date of Enlistment or Commissioning *

YYYY

Date of Discharge

YYYY

Type of Discharge *

Branch of Service *

Air Force

Army

Coast Guard

Marine Corps

Navy

Army/Air National Guard

Other:

Required

Did you serve at least 30 days Active Duty?

Yes

Clear selection

Type of Service *

Active

Reserves

Guard

Please select your interests: *

Events (Assist with WVNM functions and staff WVNM table at military events)

Media (Facebook, Instagram, Website & Calendar)

Albuquerque Veteran Memorial Museum volunteer (3hrs)

Assistance Team (outreach to other veterans)

Community liaison on behalf of WVNM

Other

Required

What else would you like us to know? *

A copy of your responses will be emailed to the address you provided.

Submit

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