Date Of 5^th - 30th Anniversary ____________________________________ (AA/TWA)

Active Employee ___ Retired Employee ___ Retirement Date ________________

Date of Retirement ___________________________________
Name _____________________________________________________________

Wife / Husbands / Partner’s name ___________________________________________

Street Address _____________________________________________________

City & State _________________________________ Zip Code ______________

Telephone Number __________________ Company Seniority Date ___________

Email Address ______________________________________________________

Date of 1st employment with AA _____________ Base ____________________

Current (or last) Position ____________________ Base ___________________

Other Positions or Bases _____________________________________________

__________________________________________________________________

Dues are $20 for both Active and Retired employees. Initial dues must accompany this application and subsequent dues are due at convention time>  (Dues are effective from convention to convention each year).  Attach check in the proper amount, payable to 3Diamond Society to this application and mail to the Treasurer:.

Jock Bethune, Treasurer at 2209 Mediterranean Ave, Arlington, TX.  76011

Applicants Signature __________________________________ Date _________