Join Veterans Recovery Network (Membership Application)

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Name
(Membership Applicant)
(if applicable)
(MM/DD/YYYY)
(if applicable):
(if applicable):
(Please select one)
Email Contact
(Use two-letter abbreviation; e.g,, New York: NY; California: CA)
Please specify your primary country of residence. If you reside in a territory of the U.S. (e.g., PR, GU, MP, VI, AS) please input as a state above, and select ‘USA’ here.
(XXX-XXX-XXXX)
Please select the type of membership you are applying for today (see drop down menu above). There is a one-time application fee of $25 for all new members. Note: Only Veteran Members may join as lifetime members. If you are a veteran’s spouse or child, please join as ‘Veteran Affiliate.’
Please select the method of payment you wish to use for fees related to this Application as disclosed above. You will receive a payment request link via email or SMS text message.
How did you hear about Veterans Recovery Network?
I, the "Membership Applicant," hereby declare that information on this Application to be true and correct, have chosen to submit this Application for membership at Veterans Recovery Network Inc., for immediate review before the Board of Membership Council, becoming immediately effective under a provisional status for thirty days from the submission and approval date of this Application.
Please select “AGREE” above only if you accept and agree to the terms and conditions under the respective organizational bylaws of Veterans Recovery Network (“VRN”) acknowledged under this Agreement. (See VRN Bylaws at https://vetsrecovery.org/bylaws)
(Please print your first/last name)