Island X-4 Toledo, Oh

APPLICATION FOR MEMBERSHIP
NAVY SEABEE VETERANS OF AMERICA

JUST PRINT THIS PAGE ON YOUR PRINTER
FILL IT OUT AND MAIL IT IN
IT IS JUST THAT SIMPLE.

I HEREBY APPLY FOR MEMBERSHIP IN THE NAVY SEABEE VETERANS OF AMERICA

I SOLEMNLY PLEDGE MYSELF TO PROMOTE THE WELFARE OF ITS MEMBERS, AND TO PERPETUATE ALLEGIANCE TO AMERICA,

TO THE AMERICAN FLAG AND TO AMERICA’S FREE INSTITUTIONS.

MEMBERSHIP FOR: Island X-4 Toledo,OH

Name__________________________________________________________________________________

Address:________________________________________________

City_____________________________________________________

State;_________________________ Zip ______________________

Phone_____________________________________

Date Of Birth__________________________

Unit(S) Served With:___________________________________________________________________

Discharge Date ________________________________
Type Of Discharge________________________________

Copy of  DD214

Name of  Spouse _________________________________

E-Mail Address:______________________________________________

Signature___________________________________________Date:______________________________________

Annual dues are $20 per year, July1 -June30. Payable at time of application and each year thereafter on June 1.

Life Membership rates based on age with the cost being:

18 to age 40 -------$180.00

41 to age 69--------$155.00

70 and over---------$130.00

Make checks payable to:
Island X-4OH 

Mail To:  DAVID YOUNGS, 3425 149th Street, Toledo, OH 43611-2528