Data Category
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Current Information
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Member Full Name # |
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USNA Class or Affiliation |
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Spouse # |
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Home Address |
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Home Address (Additional) |
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Home City, State |
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Home Zip |
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Home Phone |
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Employer |
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Business Address |
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Business Address |
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Business City, State |
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Business Zip |
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Business Phone |
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Email Address |
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# These names will also be used for your name tags.Please select one of the choices below:
Dues:
$25 ($10 for active duty personnel) for 12 months. $40 for 24 months. Please make checks payable to “USNA AA CT Chapter.”
Mail this form to:
Tom Hogsten ’85, 27 Bobwhite Trail, Gales Ferry, CT 06335.