Well your topic specified 2005 so I will use that.

Create a new ToolStripMenuItem like so:
Code:
Dim myNewToolStripMenuItem as New ToolStripMenuItem
Now you can add it to the existing menu like so:
Code:
myExistingMenu.Items.Add(myNewToolStripMenuItem)
By the way, those examples were found by viewing the designer.vb file in my project.