Island X-12,West Palm Beach,FL

APPLICATION FOR MEMBERSHIP
NAVY SEABEE VETERANS OF AMERICA

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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-12, West Palm Beach, FL

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-12FL 

Mail TO: Secretary X-12FL
5600 No. Flagler Dr. Apt. 1907
West Palm Beach, FL 33407-2651

Tel: 561-881-8245