MEMBERSHIP APPLICATION FOR THE COMBINED ASSOCIATION FOR:

 

 

Jerry Guetschow (Treasurer)

2424 S. Belmont Dr.

Beloit WI. 53511-8420

 

415-467-6284 E-Mail Address: AD24History@att.net

 

MEMBERSHIP APPLICATION

Please accept my name for membership YEARLY DUES: $25.00

Please make check payable to: Your Ships Hull Number "AD24, AV7, AV12, AV4, or TPM Torpedoman" and mail to the address listed on the top of this application.

The Combined Association IS or IS NOT (Circle One) Authorized to Publish

My Name & Address in connection with Association Business  

(Except: ROSTER OF MEMBERS TO MEMBERSHIP).

Name Print: ___________________________________________________________

Address Print: _______________________________________________________

Ship Info Yr Aboard: _________________________________________________

Rate / Rank: _________________________________________________________

Division: ____________________________________________________________

Phone Number:     _______________________________________________________

E-Mail Address: ______________________________________________________

DATE:___________________  SIGNATURE:__________________________________