USS SEA ROBIN ASSOC

MEMBERSHIP APPLICATION

Please enroll me as a member of the USS SEA ROBIN ASSOCIATION

PLEASE PRINT CLEARLY

DATE: ________________

NAME: ________________________________________________________

STREET: ________________________________________________________

CITY : _________________________________________

STATE : ___________________ ZIP:___________-________

PHONE: ________________________________________

EMAIL: _________________________________________

Spouse/Partner: __________________________________

Rate/Rank on SS-407 ______________ Years Served on Board: From _____ to _______

FEE INCLUDED - Check one

INITIAL APPLICATION $20.00 ____ or ANNUAL RENEWAL $10.00 ____

or

LIFE MEMBERSHIP: UNDER AGE 62 - $150.00 ____ AGE 62 AND OVER - $100.00 ____

NOTE: If you served on the USS Sea Robin during a WWII war patrol, you are considered a LIFE MEMBER of the Association. NO DUES

I served on USS Sea Robin during WWII War Patrol # ___ ___ ___

ALL CHECKS should be made payable to: USS SEA ROBIN ASSOC

RETURN TO:

PAUL ROGGEMANN

42 Hemlock Dr

Hopewell Jct NY 12533

progg@frontiernet.net