VA 0918E Associate Member Application

OMB Approved Number 2900-0921
Respondent Burden: 20 Minutes
Expiration Date: Sept. 17, 2023

VETERANS DAY NATIONAL COMMITTEE
DEPARTMENT OF VETERANS AFFAIRS
OFFICE OF PUBLIC AND INTERGOVERNMENTAL AFFAIRS
ATTN: VETERANS DAY COORDINATOR (002D)
810 VERMONT AVENUE, NW
WASHINGTON, DC 20420

ASSOCIATE MEMBERSHIP APPLICATION
1. ORGANIZATION

DATE
SUBMITTED
2. BUSINESS ADDRESS (Include City, State and Zip Code)

3. BUSINESS TELEPHONE NUMBER 4. BUSINESS FAX NUMBER

5. BUSINESS EMAIL ADDRESS

6. WEB PAGE ADDRESS

7. CURRENT NATIONAL PRESIDING OFFICER

8. WHAT IS THE MAIN PURPOSE OF YOUR ORGANIZATION

9. WHY DO YOU WISH TO JOIN THE VETERANS DAY NATIONAL COMMITTEE (VDNC)

11. WHAT PERCENTAGE OF YOUR
MEMBERSHIP CONSISTS OF
VETERANS

10. WHAT IS THE SIZE OF
YOUR MEMBERSHIP
12. MEMBERSHIP QUALIFICATIONS

13. DATE FOUNDED

14. NUMBER OF ACTIVE
CHAPTERS

15. NUMBER OF STATES WITH 16. DO YOU HAVE NATIONAL BY-LAWS OR A
ACTIVE CHAPTERS
CONSTITUTION (If yes, please attach a copy)
YES
NO

17. DO YOU HAVE AN ANNUAL NATIONAL CONVENTION (If yes, please
attach a program from your most recent convention)
YES
NO
19. NAME OF PUBLICATION

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MAR 2023 0918e

18. DO YOU PRODUCE ANY PERIODIC PUBLICATIONS (If yes,
please include the last three issues with your application)
YES
NO
20. FREQUENCY OF
PUBLICATION

21. DATE OF FIRST ISSUE

22. IS YOUR ORGANIZATION FEDERALLY CHARTERED AND/OR RECOGNIZED OR APPROVED BY THE SECRETARY OF VETERANS AFFAIRS FOR
PURPOSES OF PREPARATION, PRESENTATION, AND PROSECUTION OF CLAIMS UNDER LAWS ADMINISTERED BY THE DEPARTMENT OF
VETERANS AFFAIRS, AS PROVIDED IN SECTION 5902 (FORMERLY SECTION 3402) OF TITLE 38, UNITED STATES CODE (U.S.C.) AND
SUBSECTION 14.628 (a) AND (c) OF TITLE 38, CODE OF FEDERAL REGULATIONS (C.F.R.)
YES
NO
IF YES, WHAT IS YOUR CHARTER'S
PUBLIC LAW NUMBER

ON WHAT DATE WERE YOU
CHARTERED BY CONGRESS

23. IS YOUR ORGANIZATION CLASSIFIED BY THE INTERNAL REVENUE SERVICE AS NON-PROFIT
(If yes, please include evidence of non-profit status, e.g., letter of determination)
24. IF ACCEPTED AS AN ASSOCIATE MEMBER/MEMBER, WILL YOUR ORGANIZATION HONOR ALL
VETERANS DAY NATIONAL COMMITTEE ASSOCIATE MEMBER/MEMBER ORGANIZATION
RESPONSIBILITIES AS DESCRIBED IN THE COMMITTEE'S BY-LAWS
25. DO YOU HAVE A REPRESENTATIVE WHO WILL ATTEND COMMITTEE MEETINGS IN
WASHINGTON, DC

YES

NO

YES

NO

YES

NO

APPLICANTS SHOULD SUBMIT SUPPORTING DOCUMENTATION TO ENABLE THE COMMITTEE TO MAKE AN INFORMED DECISION

SIGNATURE (Ink signature)

TITLE

DATE

PLEASE SEND THIS APPLICATION VIA EMAIL: vetsday@va.gov
SUSPENSE FOR APPLICATIONS IS JUNE 1, 2023

RESPONDENT BURDEN: VA may not conduct or sponsor, and the respondent is not required to respond to this collection of information
unless it displays a valid OMB Control Number. Public reporting burden for this collection of information is estimated to average 20
minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data
needed, and completing and reviewing the collection of information. If you have comments regarding this burden estimate or any other
aspect of this collection of information, call 1-877-222-8387 for mailing information on where to send your comments.
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MAR 2023 0918e