RETIRED  SEABEE  DIRECTORY  APPLICATION

 

 

 

CHECK THE PROPER BOX(ES)

 

[  ]  Please include my name and address in the Retired Seabee Directory.  I am a honorably retired Seabee with at least 20 years service in the Navy and/or Naval Reserve.   Or, I am retired with less than 20 years service either medically or under the provisions of the TEMA Program.  (This also includes retired Civil Engineer Corps officers and “H” Company personnel who have served at least one tour with the Naval Construction Forces.)

 

[  ]  Please send me a copy of the current directory.

 

PLEASE PRINT CLEARLY:

 

 

Name:_______________________________________________Rate/Rank__________

             LAST                                                           FIRST                               MI

 

Address:________________________________________________________________

                    STREET

 

              ________________________________________________________________

                   CITY                                                                                         STATE                 ZIP + 4

 

Phone (Optional):________________________________________________________

 

E-mail (Optional):________________________________________________________

                             PLEASE PRINT IN CAPS; CIRCLE LETTERS THAT ARE TO REMAIN IN CAPS IN E-MAIL ADDRESS

 

Signature ____________________________________  Date_____________________ 

 

Note:  If you have additional information you wish to include, such as an alternate address, or a cell or FAX number please add it to this application.

 

 

Alternate Address: __________________________________________

                                     Street

 

                                ___________________________________________

                                City                                          State       Zip Code (+4)

 

 

Alternate Phone (optional): __(______)____________________________

 

The staff is made up of volunteers who donate their time and talents.  There is no pay involved and in most cases no reimbursement for minor expenses.  Major expenses are met by donations of the members. Although there is a suggested donation amount ($12.00 this year), donations are not mandatory. 

 

 

Mail your application to:     RETIRED SEABEE DIRECTORY              Phone: (228) 255-9687

                                                Attention: Glen Kellerman

11257 Vidalia Road                                           E-mail:  EQPACKRAT@aol.com

                                                Pass Christian, MS 39571-9057                          

 


                                                                                      Back