Associate Membership Application

Mission Statement

The Paralyzed Veterans of America Wisconsin Chapter will improve the quality of life of United States Military Veterans and others who have Spinal Cord Dysfunction through the use of Education, Communication, Advocacy, Legislation, Research, and Sports and Recreation. PVA has several members and friends volunteering their time in an effort to accomplish this mission. We encourage Associate Membership to those individuals interested in aiding our cause. Associate membership has the same rights and privileges as regular membership, except Associate Members do not have voting rights. Eligibility for Associate Membership involves an interest in our goals and objectives, support of our organization, and a commitment to following policies and procedures when representing the chapter. The PVA-WI Board of Directors (BOD) makes all decisions on Associate Membership status.

Last Name

First Name

Address

City

State

ZIP

Phone

Alternate Phone

Gender

Date of Birth

Do you have a Spinal Cord Injury or Disease?

Are you a veteran?

Optional: there is no cost for Associate Membership in PVA-WI; however, donations are gratefully accepted and are 100% tax-deductible. If you make a donation now or in the future, you will receive a letter acknowledging your charitable contribution for your tax purposes. As an Associate Member of PVA-WI, you will receive our quarterly newsletter, and you may contact us at any time for information, comments, or questions.

Signature

Date