City/Town:___________________ State: _______ Zip Code: ________
Telephone: __________________ Email: _______________________
2019 Dues: ($20.00) ____________
2020 Dues: ($20.00) ____________
2021 Dues: ($20.00) ____________
Donations: ___________________ Thank you,
For new members
please indicate year(s) you served on board
(2019 dues are
from January 2, 2019 to December 31, 2019)
Please check your mailing label on the newsletter, the date indicated after your name reflects the year that your dues is paid through.
Please advise of address and information changes as they occur or you may get lost.If you know of a shipmate that has passes, please notify us. Thank you.