United States Submarine Veterans Inc. Groton Base
APPLICATION FOR MEMBERSHIP

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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 for Groton Base Membership Only

Associate Applicant is (Check one): 

Veteran
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)

Name & Hull Number

 

 
Spouse of Veteran
Other (specify) 
Note: If additional room is needed attach a separate sheet.

NATIONAL DUES:
Annual:  $20 (1st year) - $10 (subsequent years) + Base Dues ($10.00).
Life:  (Age 65 + = $50)  (55 to 65 = $100)   (45 to 55 = $150)  (Under 45 = $250) + Annual Base Dues ($10.00).
 		   

 

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
 

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Name & Hull Number

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Name & Hull Number

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Name & Hull Number

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Name & Hull Number

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Name & Hull Number

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Name & Hull Number

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Name & Hull Number

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Upon completion, please deliver or mail with dues to:
 
U.S. SUBVETS; ATN: BASE COMMANDER; 40 School Street; Groton, CT 06340

 

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. 27 Nov. 2000

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