Island X-1, Selma, NC

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-1, Selma, NC

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-1NC 

Mail TO:Secretary: Jim Massengill
           314 Davis Farm Dr.
           Selma, N.C. 27576
Ph. No.:    919-965-3315
Fax. No.:   919-965-0135
E-Mail:     JMasseN317@oal.com