Island X-5, West Valley, AZ
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-5, West Valley, AZ
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-5AZ
Mail To: ROBERT J. DAY, 5201 W. Echo Ln., Glendale, AZ 85302-6207
Tel: 623-842-0618, e-mail: uccmrjday@cox.net