elsie item issue 67 - USS Landing Craft Infantry National Association

USS LCI NATIONAL ASSOCIATIONAPPLICATION FOR MEMBERSHIPIf you served aboard an LCI, you are eligible to join our Association as a regular member.If you are a relative of someone who served aboard an LCI or if you just have a desire to have a part in rememberingthose who so served, you are invited to join as an Affiliate.DUES ARE $25.00 PER YEAR, June 1 through May 31.Please complete this form and mail it to the address indicated below with your first year’s dues.I. For Application as a Regular Member:Name______________________________________________________________________________________________________LCI Served On _______________________ Rank/Rate___________________________________Address: ___________________________________________________________________________________________________City________________________________________________ State_________________ Zip Code________________________Phone (__________) ____________________________ E-Mail address_______________________________________________Date of Birth____________________Occupation or Former Occupation_______________________________ Wife’s name___________________________________Help, please! As a precaution we’d like to have an alternate name and address that we might contact in case we can’t reach you:Alternate Name_____________________________________________________________________________________________Address: ___________________________________________________________________________________________________City________________________________________________ State_________________ Zip Code________________________Phone (__________) ____________________________ E-Mail address_______________________________________________II. For Application as an Affiliate:Name______________________________________________________________________________________________________Address: ___________________________________________________________________________________________________City________________________________________________ State_________________ Zip Code________________________Phone (__________) ____________________________ E-Mail address_______________________________________________Date of Birth____________________Occupation ____________________________________ Spouse’s name ______________________________________________My _________________________ (father, grandfather, uncle, etc.) whose name is/was _________________________________served on LCI Number______________________ (If unknown or if you did not have a relative who served on an LCI, leave blank)My Occupation _______________________________ Spouse’s name _______________________________________________Help, please! As a precaution we’d like to have an alternate name and address that we might contact in case we can’t reach you:Alternate Name_____________________________________________________________________________________________Address: ___________________________________________________________________________________________________City________________________________________________ State_________________ Zip Code________________________Phone (__________) ____________________________ E-Mail address_______________________________________________Privacy notice: Information solicited in this application for membership will be used only as needed for official business within theAssociation. No information will be released outside the Association or its agents without the consent of the member(s) concernedMake Check payable to: USS LCI NATIONAL ASSOCIATIONSend Application and Check to:USS LCI National Associationc/o Nehemiah Communications, Inc.101 Rice Bent Way, #6Columbia, SC 2922931