Join Our Chapter

Member Data

Data Category

Current Information

Member Full Name #
USNA Class or Affiliation
Spouse #
Home Address
Home Address (Additional)
Home City, State
Home Zip
Home Phone
Business Address
Business Address
Business City, State
Business Zip
Business Phone
Email Address

# These names will also be used for your name tags.Please select one of the choices below:

$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.