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Application for Yakima Base Membership |
OUR CREED: To perpetuate the memory of our shipmates who gave their lives in the pursuit of their duties while serving their country. That their dedication, deeds and supreme sacrifice be a constant source of motivation towards greater accomplishments. Pledge loyalty to the United States Government.
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| Name: | New Application or Chapter Transfer?: |
| Address: | Area Code and Telephone Number: |
| City, State, Zip code: | Internet E-Mail Address: |
| Date of Birth: | Dates of Service & highest rank/rate: |
| Spouse Name or next of kin: | First Qualified on what Submarine & When? - 1 |
| Other Boats served on - 2 | Other Boats served on - 4 |
| Other Boats served on - 3 | Other Boats served on - 5 |
I certify that I am a U.S. Citizen and I 'qualified in submarines' aboard a US Navy Submarine. I subscribe to the creed of the United States Submarine Veterans, Inc. and agree to abide by all laws and regulations governing the United States Submarine Veterans, Inc. (USSVI) so long as they do not conflict with my civil or military obligations.
Enclosed with this form is my $ 30.00 initial dues. Initial National USSVI: $ 20.00/Local Chapter $ 10.00)
NOTE: ADDING A BASE OR TRANSFERRING? USSVI MEMBERS PAY CHAPTER DUES ONLY
| Signature & Date: | Chapter Sponsor or Membership Chair Sign-off: |
Mail this application for membership with your check, payable to
USSVI c/o Base Commander, 619 Pleasant Avenue, Yakima, WA 98902-4387
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(Rev. Date May 11, 2002)