MEMBERSHIP APPLICATION Please fill out this form as a double check to ensure we will be expecting a SIGNED formal application and a check or money order for your initial dues in the mail shortly. By filling out this form all your information will be entered on a spreadsheet automatically and it will save us tremendously the amount of time to enter this information. PLEASE USE ALL CAPITAL LETTERS, except for the e-mail address. This information will also be used for our roster, except the personal information. Our rosters are only sent to the members. Please use your legal name and full middle name, no nicknames here. You can have any name or nickname on your name badge at the reunions. You will be able to change your name on the roster if you prefer a nickname. If you have both a unisex first and middle name such Lynn or Jamie, please let us know which gender you are. We will definitely need to know this information for our buddy system for reunions. Thank you.

* indicates required fields    *FIRST NAME - NO NICKNAMES PLEASE:   *MIDDLE NAME - FULL NAME PLEASE:   *LAST NAME:   SPOUSE'S FIRST NAME:   *HOME STREET ADDRESS:   *CITY:   *STATE:   *ZIP CODE:   MAILING ADDRESS (If different):   *MEMBER'S BIRTH DATE:   SPOUSE'S BIRTH DATE:   ANNIVERSARY DATE:   *TELEPHONE NUMBER:   *E-MAIL ADDRESS OR WRITE "NONE":   *NAME OF SHIP OR SQUADRON:  USS MIDWAY  USS FRANKLIN D. ROOSEVELT  BOTH  DID NOT SERVE ON EITHER SHIP-SERVED IN A SQUADRON ON "SQUADRON LINKS" PAGE ON WEB SITE  OTHER - I AM A VETERAN OF THE U.S. ARMED FORCES AND DO NOT HAVE A REUNION ORGANIZATION TO JOIN  I WOULD LIKE TO JOIN AS A NON-VETERAN WITH HONORARY STATUS FROM MY SPONSOR   *DEPARTMENT, DIVISION, SQUADRON OR DETACHMENT:   *YEARS ABOARD OR IN SQUADRON EXAMPLE 1965 - 1967:   *PLANKOWNER (On Ship when commissioned or re-comm):  YES  NO   *RATE & RANK AT DISCHARGE (Example BM2):   PRESENT OR FORMER OCCUPATION:   *SPONSOR'S LAST NAME OR WRITE "OFFICE":   *SPONSOR'S MEMBERSHIP NUMBER IF "OFFICE" 0 0 0 0:   *Do You want your street address on the roster?:  YES  NO   *Do you want your telephone number on the roster?:  YES  NO   *Do you want your e-mail address on the roster?:  YES  NO   ARE YOU RETIRED?:  YES  NO   *WHAT TYPE OF MEMBERSHIP:  REGULAR  LIFETIME  AUXILIARY  SPOUSE AUXILIARY  2ND GENERATION AUXILIARY  3RD GENERATION AUXILIARY  WIDOW  WIDOWER  DOCENT  OTHER   *HOW DID YOU LEARN ABOUT THIS WEB SITE?:  RECEIVED A LETTER FROM THE OFFICE  RECEIVED AN E-MAIL FROM THE OFFICE  CALLED BY THE OFFICE  A FRIEND TOLD ME  A MEMBER TOLD ME  SEARCHING THE INTERNET  FACEBOOK  BUMPER STICKER  OTHER   NAME OF MEMBER WHO TOLD YOU:   YOUR CELL PHONE:   WANT TO ATTEND REUNION IN DAYTON IN 2017?:  YES  NO   WANT TO ATTEND REUNION IN TUCSON IN 2018?:  YES  NO   WANT TO ATTEND REUNION IN BUFFALO IN 2019:  YES  NO   WANT TO ATTEND REUNION IN HONOLULU IN 2020:  YES  NO   WANT TO ATTEND REUNION IN OMAHA IN 2021:  YES  NO

Please click on the Submit button after you answered all the required fields. Please do not hit the SUBMIT more then once because multiple on-line applications will be generated. Please now go to the web page labeled "Printable Form" and print out the Formal Membership Application form that needs to be signed and sent into the office. DO NOT PRINT OUT THIS FORM AND SEND IT INTO THE OFFICE. Thank you.

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