Island X-19, Syracuse, NY

APPLICATION FOR MEMBERSHIP
NAVY SEABEE VETERANS OF AMERICA

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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-19, Syracuse, NY

Name__________________________________________________________________________________

Address:________________________________________________

City_____________________________________________________

State;_________________________ Zip ______________________

Phone_____________________________________

Date Of Birth__________________________

Unit(S) Served With:___________________________________________________________________

Discharge Date ________________________________
Type Of Discharge________________________________

Name of  Spouse _________________________________

E-Mail Address:______________________________________________

Signature___________________________________________Date:______________________________________

Annual dues are $ 20.00 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-19NY 

Mail TO:

Secretary : Daniel L.Gordon, 113 Stonecrest Drive, DeWitt, New York 13214-2428

 telephone 315-445-0434; E-Mail  dgordon32@twcny.rr.com