Navy Seabee Veterans of America, Inc.

 National Island at Large

APPLICATION FOR MEMBERSHIP


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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: National Island at Large

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 $20.00 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: NSVA Island at Large
Mail To:

SEC'Y: RICHARD E. HOFFMAN, 1431 S. Ocean Blvd. #62, Lauderdale-by-the-Sea, FL 33062-7302
  Tel:  954-942-9544,  FAX:  954-943-8523,  e-mail:  seabees27@earthlink.net