VVA/AVVA Deceased Member Notification

Deceased Member Name *

Deceased Member Number *

If VVA, AVVA Life Member, please specify

VVA Chapter Number *

Name and Title of Chapter Official Completing Notification *

Chapter Street Address: *

Chapter City/State/Zip *

If available, please attach a copy of the obituary from the local newspaper

Select Document

Remove his/her name from the roster and advise all elected and appointed officials and departments as appropriate:

Date Member Passed Away *

Date of Birth *

Can be found on the deceased's DD-214 on file

Place of Birth *

Can be found on the deceased's DD-214 on file

Branch of Service *

Dates of Service in Vietnam *

mm/dd/yy - mm/dd/yy

Cause of Death *

Comments or Special Requests

Honorary Life Membership Card and Certificate

We extend our heartfelt sympathy to the surviving spouse of all deceased Life Members and offer a distinctive Honorary Life Membership Card and Certificate in recognition of the life-long commitment made before his/her death.

We request the distinctive Honorary Life Membership Card and Certificate for presentation to the surviving spouse. Please forward the card and certificate to the chapter official identified above.

Opt In

Next of Kin

Street Adress

City/State/Zip

Phone Number

The surviving spouse does not wish to receive the distinctive Honorary Life Membership Card and Certificate. Please do not prepare nor send the card and certificate.

Opt Out