United States Submarine Veterans Inc.

APPLICATION FOR MEMBERSHIP

Type your data into the boxes and proof for accuracy

When this form is completed

USE YOUR BROWSER PRINT FEATURE TO PRINT OUT APPLICATION

Regular  Life  Associate 

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 toward greater accomplishments. Pledge loyalty and patriotism to the United States Government”


I subscribe to the Creed of the United States Submarine Veterans, Inc., and agree to abide by the Constitution, all Bylaws, Regulations and Procedures governing the U.S. Submarine Veterans, Inc., so long as they do not conflict with my military or civil obligations. I will furnish further proof of my eligibility for Regular or Life membership, including an Honorable Discharge and U.S. Navy (SS) Designation, if required by proper authority.

 

Date: (MM/DD/YY)

Name:

Signature:                                                                                                                                                                                      

Address:

City:

State:

Zip Code:

Tel (Include area code):

E-Mail Address:

Base Desired:

Sponsor:

 

 

This box is for Associate applicants or for Groton Base Membership Only

Associate Applicant is (Check one): 

Veteran

Spouse of Veteran

Other (specify) 

Note: If additional room is needed attach a separate sheet.

NATIONAL & BASE COMBINED DUES:

Annual:  5 Yr Term:  $140.00 - 3 Yr Term: $85.00 - 1 Yr Term:  $30.00

Life:  (Age 76 + = $100)  (66 to 75 = $200)   (56 to 65 = $300)  (46 to 55 = $ 400.00) 

(Thru 45 = $500)   NOTE:  National Life Dues do not include Base Dues.

Annual Chapter (Base) Dues: (NOTE:  A few bases have a supplemental additional charge for local projects)

BIOGRAPHICAL DATA
(New Members/Updates/Changes)

Please provide the information requested below. This information will be retained in the National and/or Base Database Individual Bases may request additional data for their specific use only.

Date Of Birth (MM/DD/YY)

Spouse

Highest Rank Attained:

Retired (Y/N)

Active Duty (Y/N)

Qual Boat - Include Hull Number

Qual Date (MM/YY)

Next of Kin if other than Spouse:

Name

Relationship: (optional)

Address

City

State

Zip:



Other Boats Served In:

Type in date as Month/Year   Example: June 1970 - Type as 06/70

Name & Hull Number

From

To

Name & Hull Number

From

To

Name & Hull Number

From

To

Name & Hull Number

From

To

Name & Hull Number

From

To

Name & Hull Number

From

To

Name & Hull Number

From

To

Name & Hull Number

From

To

Upon completion, please deliver to:

Your Base Secretary , or if you do not know of a base location near you,


Mail to: USSVI National Office, P.O. Box 3870, Silverdale, WA  98383-3870

Applicants serving on active duty are requested to provide a permanent address through which they may be contacted. (Continue on back if necessary)
     

USSVI Apform Rev. 21 Sept. 2005