Print form and mail to appropriate address listed below

U.S.S. VIRGO Association
Registration, Dues and Information Update Form

PLEASE PRINT CLEARLY

Your Name                                                                                                    

Spouses First Name                                                                                       

Address                                                                                                        

City                                                                                                              

State               Zip Code                      Telephone                                           

Fax                                           E-mail                                                          

Your Web site                                                                                               

Dates Served WWII                           Dates Served Korea                          

Dates Served Vietnam                           Other Dates Served                          

Rate                           Rank                           Division                          


YEARLY DUES: $10.00
Make All Checks Payable to:
U.S.S. VIRGO ASSOCIATION

Home Address / Email  Address Changes and
Other Notices From Members For The Newsletter


Reunion Registration 

ACTIVE MEMBERS
Send Renewal Dues for
July 1 - June 30

U.S.S. VIRGO ASSOCIATION
Steve Wamsley, Treasurer
191 Strickland Rd.
Piketon OH  45661
Email:
selres@verizon.net