U.S.S. INTREPID ASSOCIATION, Inc. Membership Application
The Membership Committee's goal: to continually increase the membership of the Association. Membership entitles free admission for yourself & a guest during normal Museum hrs as many times as you wish (Admission not permitted when the Museum is closed)-Exceptions: meetings/work projects/Association events. Membership includes The Ketcher Bulletin published 6x/yr; invitations to any Association Events; eligibility for family members to apply for Scholarships, & participation in the Association. Your dues and donations made to the Association are used for the following projects:
REUNION ▪ NEWSLETTER ▪ FLAG PROGRAM ▪ SPECIAL PROJECTS ▪ SCHOLARSHIP FUND
Mail Application with check to: USS Intrepid Association, PO Box 140471, Staten Island, NY 10314
Date of Application: __________________Recruited by:_______________________________________
Name of Applicant:___________________________________Date of Birth:_____________________
Last First
Address:____________________________________________________________________________
Street City State Zip
Phone: _______________Cell:_______________ Email: __________________________________________
( ) Former Crewmember
Dates Onboard: ________________Rank/Rating:__________Unit/Division: ____________________
( ) Veteran (Non Former Crewmember)
Branch of Service:_________________________Dates of Active Service:_______________________
Rank-Rating :________________________Duty Station :_______________________________________
( ) Relative (Spouse, Widow, Direct descendent)
Name of FCM:____________________________ Dates on Board:_____________________________
Relationship to Former Crewmember:_____________________________________________________
( ) Friend of the Assoc. (Non Former Crewmember, Non Veteran, Non Relative)
Dues are $25 per year - $250 for Life Membership
Please make check payable to: USS INTREPID ASSOCIATION, INC.
Enclosed is the following amount: ( ) Membership ($25) ( ) Life Membership ($250) Chk #:______
All memberships are Effective 1 January to 31 December of each year. (revised 3/09)