Retiree Council

Membership

NEBRASKA MILITARY RETIREE COUNCIL MEMBERSHIP FORM

Nebraska Military Retiree Council
1776 N. 10th Street
Lincoln, NE. 68508-1090

Membership is $5.00 per year and you can pay up to 10 years.

My remittance of $_______is for ________years.

Name ________________________________________________________________

Address ______________________________________________________________
(City) (State) (Zip Code)

Home Phone Number ____________________________________________________
(Area Code & Number)

Name of Spouse ________________________________________________________

Branch of Service _______________________________________________________

E-Mail Address _________________________________________________________

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Revised May 30, 2011

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