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Online Membership Form
APPLICATION MEMBERSHIP NAVY CLUB USA SHIP 35 USS INDIANAPOLIS. COPY OF DD-214 REQUIRED AT FIRST MEETING. ***NOTE, ONCE YOU SUBMIT FORM, YOU WILL HAVE OPTION TO CLICK ON LINK TO PAY DUES***
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First Name
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Middle Initial
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Last Name
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Date
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Address Line 1
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Address Line 2
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City
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State
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Zip
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Home Phone
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Cell Phone
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E-mail
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Spouse's Name
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Military Status
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Honorably Discharged Date
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Branch of Service
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Rate or Rank
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Navy Rating, MOS, Specialty (military job)
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Years of Service
Example: 2008-2012
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Did you receive an "Honorable Discharge"?
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Civilian Occupation
Title and Employer
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Retired
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Ship Preference:
What ship would you like to join?
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Ship #35 - USS Indianapolis
Nearest to home
Member-at-large
Other:
Recruited by
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