USS Plymouth Rock Ships Association - LSD29
Application for Membership
Please complete the following so that we can acquire information about your naval career and time aboard the Plymouth Rock. This information will become part of our database of Association Members
Name (First and Last)_______________________________Spouse_______________
Address:_______________________________________________________________
City:
Phone:_________________________ FAX:_________________________________
E-Mail:_________________________________
Month/Years Served Aboard the Plymouth Rock: (From)________ (To) ________
Ranks or Ratings While Onboard (From)________ (To) ________
Total Years of Naval Service: (From)_____________ (To) ______________
Rank or Rating at Retirement___________________
Other Ships Served on or Duty Stations Assigned:
1.
________________________________________________________________
2. ________________________________________________________________
3. ________________________________________________________________
4. ________________________________________________________________
5. ________________________________________________________________
BI-ANNUAL DUES FOR USS PLYMOUTH ROCK ASSOCIATION MEMBERSHIP IS $25.00 DUES ARE PAID FROM REUNION TO REUNION, AND DUES FOR 2009-2010 ARE NOW DUE. PLEASE MAKE CHECKS PAYABLE TO THE USS PLYMOUTH ROCK ASSOCATION.
Signature___________________________________ Date:___________________
RETURN THIS FORM TO: Paul Mohawk, Treasurer,