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Auxiliary Membership Form.gif (5644 bytes)

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Please print this form and fill in the information

Membership fee: $10.00 per year

Jan through Dec
or
$50.00 Life Membership

First Name ______________________________
Last Name ______________________________
Street Address ______________________________
City ______________________________
State/Province ______________________________
Zip/Postal Code ______________________________
Husband's Name ______________________________
Ship Name ______________________________
Ship Number ______________________________
Home Phone ______________________________
Work Phone ______________________________
Email Address ______________________________
Webpage URL ______________________________

Did someone tell you about About/Encouraged You to Join DESA Ladies Auxiliary? If yes, please tell us their name:

 

Make Check Payable to: DESA Ladies Auxiliary

Mail this form and membership fee to:

Elaine Adriani
11 Button Rd.
Shelton, CT 06484

Thank You and Welcome Aboard!

 

 

Back To The Ladies Auxiliary Page

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Home | Site Map | Members | Chapters | News | Reunions | In Remembrance | Veterans Tribute | Roll of Honor | Photo Library | History | Web Sites Related Links | Locate DE & Shipmate Information | Archives | About DESA | Join DESA | Contact DESA  | Directors | Ladies Auxiliary