USS SAVANNAH (AOR 4) ASSOCIATION Online 2011-2012 Membership Application / Renewal If you are renewing your membership, you do not need to complete all the information below unless you have recent changes. The current and onboard SAVANNAH info is maintained in our database. Current info is not published nor given out to any third party. CURRENT INFO: Last Name: ___________________________________ First Name: __________________________________ Middle Initial: ______________________________ Street or Box No: ______________________________________ City: ________________________________________ State: ________ ZIP Code: __________________ eMail address: ____________________________________________________ Currently on active duty (Y or N): _______ ONBOARD SAVANNAH INFO: Year reported aboard: ________ Plankowner (Y or N): ______ Highest Rank/Rate : __________ Department: ________________________________ Division: __________________________________ Decomm Crew (Y or N): __________ Year departed SAVANNAH: _____________ * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * Dues are $25.00 (Wavied for active duty personnel) Membership expires December 31, 2012 Make check payable to: USS SAVANNAH (AOR 4) Association Mail form and check to: USS SAVANNAH (AOR 4) Association 63 Chamberlain Street Skowhegan, ME 04976