U S S  INTREPID ASSOCIATION, Inc.

  Membership Application

 

                  The Membership Committee has a goal to continually increase the membership of the Association.  Membership entitles you to free admission for yourself and a guest during normal Museum hours as many times as you wish.  Admission is not permitted when the Museum is closed – exceptions – meetings, work projects or Association events.

Your Membership includes The Ketcher Bulletin published FOUR times a year.  You are also invited to any Association Events, eligibility for children & grandchildren to apply for Scholarships and participation in the Association.  Your dues and donations made to the Association are used for the following projects:

REUNION ▪ NEWSLETTER ▪ FLAG PROGRAM ▪

SPECIAL PROJECTS ▪ SCHOLARSHIP FUND

 

Mail Application with check to:                       USS Intrepid Association

PO Box 654

Bingham, Maine 04920-0654

memberscvs11@aol.com

 

 

Date of Application:                                                    Recommended by:                                                                

 

Name of Applicant:                                                                                           _____Date of Birth:  ____________

Last First

 

Address:                                                                                                                                                                    

                                   Street                                                 City                               State                  Zip

 

Phone                                                   Cell:                                        Email:                                                            

 

Please make check payable to: USS INTREPID ASSOCIATION, INC

 

Please choose one

 

           Former Crewmember

 

Dates Onboard                                                   Rank/Rating:              Unit/Division:                                    

 

           Veteran (Non Former Crewmember)

 

Branch of Service:                         Dates of Active Service:                              

Rank-Rating                                                               Duty Station                                                               

 

_____   Relative (Spouse, Widow, Direct descendent)

 

Name of FCM___________________________________ Dates on Board_______________________

Relationship to Former Crewmember____________________________________________

 

_____   Friend of the Assoc. (Non Former Crewmember, Non Veteran, Non Relative)

 

 

I have enclosed the following amount:            (     )  Membership ($25)                $                     

(     )  Life Membership ($250) $

All memberships are Effective 1 January to 31 December of each year.                                        (revised 6/10)