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, Atlanta, GA
Name__________________________________________________________________________________
Address:________________________________________________
City_____________________________________________________
State;_________________________ Zip ______________________
Phone_____________________________________
Date Of Birth__________________________
Unit(S) Served With:___________________________________________________________________
Discharge Date ________________________________
Type Of Discharge________________________________
Copy of DD214
Wife’s Name _________________________________
E-Mail Address:______________________________________________
Signature___________________________________________Date:______________________________________
Annual dues are $12.50 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-1GA
Mail TO:
| SEC'Y: | WILBUR J. DOCKERY, 279 Shiloh Church Rd., Waco, GA 30182-2126 | |
| Tel: 770-574-9969, e-mail: jdockery39@bellsouth.net |