Membership Form
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VP-4 Association

Membership Application/Renewal

*When you fill out this form, and submit the information you will be taken another page that should be printed out and mailed along with dues.

Name Info

Last Name: First Name: MI:
Nickname: Spouse Name: Spouse Nickname:

Address Info

Street: City: State:
Zip Code:        

Contact Info

Home Phone: Cell: Primary Email Address: 
Alt Email Address:  Your Website URL:    

Service Info

U.S. Navy Retired?            
Years served in VP4:  Second tour? Second tour years:
What were your duties in VP4? (Rank/Crew/Dept/Org/etc.)
Additional Remarks/Comments
If you were recruited to join by a current member of the VP-4 Veterans Association, please provide the name of the member.
Sponsor: 
Funding an association of this size, shipmates from the 1940s to the present is expensive. The VP-4 Veterans Association Committee is asking you to participate by sending in either your $20.00 2010-2011 Annual or $100.00 LIFETIME dues. These funds are used to help cover the costs of materials, mailing, and other association and reunion-related expenses.
Dues Enclosed: $20.00 (Total for 2 years) 2010-2011
  $100.00 LIFETIME
2011 Reunion Attendance
I DO PLAN to attend the 2011 Reunion.
I DO NOT PLAN to attend the 2011 Reunion.
 

Please make your check payable to VP4 Association #902-9463 and mail to:

VP-4 Veterans Association
c/o Larry Hames
21015 124th Ave E

Graham, WA  98338-8847

*Please click submit only once*

Last updated 12 May 2010

 

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