MEMBERSHIP APPLICATION 
                      U.S.S. ENTERPRISE CV-6 ASSOCIATION 

REGULAR MEMBERSHIP: Issued to Officers and Men who served in U.S.S. ENTERPRISE CV-6
during her commissioned service, or her pre-commissioning crew.

Your first time payment of dues entitles you to a beautiful 17x24 inch parchment
Certificate of Membership. It includes your NAME, RANK or RATING,
DIVISION/DEPARTMENT/SQUADRON, with a Silhouette of the ENTERPRISE in background.
Please allow a minimum of 8 weeks for delivery of Certificate to REGULAR members.
Additional certificates can be issued for for $15.00 each.

Please complete #1 through #7 below. The information supplied will be used to
engrave and process your Certificate. 

ASSOCIATE MEMBERSHIP: Issued to immediate family members of REGULAR Members. Please
complete #1 through #3 below.

AFFILIATE MEMBERSHIP: Issued to other than REGULAR or ASSOCIATE Members. Please
complete #1 through #3 below.

#1 NAME____________________________________________ SPOUSE_____________________

#2 ADDRESS___________________________________________PHONE # (____)____________

#3 CITY____________________________ STATE____________________ ZIP______________

#4 RANK or RATING (Highest held while on board)________________________________

#5 DIVISION/DEPARTMENT/SQUADRON________________________________________________

#6 DATES ON BOARD:  From (Mo & Yr)________________ To (Mo & Yr)________________

#7 HAVE YOU RECEIVED YOUR CERTIFICATE PREVIOUSLY?   Yes__________  No__________

    Membership Cards will be issued to all Members on receipt of dues, and Members
    maintaining current dues will be on our mailing list for issuance of CV-6
    Association Bulletins, published twice a year.

    If you are not sure of your membership status, or not sure if your dues are
    up-to-date, please call Pauline.

Dues:  First Application ____________   Renewal ____________

    TWO YEAR membership -  $25 (Two year period expires in July, two years after
                                joining or renewing).
    LIFE MEMBERSHIP     - $100 

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PLEASE COMPLETE THE ABOVE AND MAIL -THIS ENTIRE PAGE- TO OUR TREASURER:

Pauline Klopfenstein, 127 Lake Street, Walkerton, IN., 46574 - Phone: 574-586-2137

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(SPECIAL NOTE: If a shipmate has passed away, we respectfully request a family
 member or friend notify us so that we may record it in our records. Also please
 notify us of any change in address or phone number.)

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For Association Use:  Date Certificate Issued________ Next Dues Date_______