USS JOSHUA Membership Application
(use this form to update your Membership information)

First Name: � � Middle Initial:

Last Name:

Rank:   Department:





State: � � Zip Code:

Daytime Telephone Number (include area code):

Alt. Telephone Number (include area code):

Email: *required

Birthday: (Please SPELL Month)

Single $20.00

Household $25.00

Would you like to:

Receive the Engage Electronically? YES   NO

Receive the Engage at the Meeting? YES   NO

Be on the Joshua List Server? YES   NO

Additional Family Members (All Members Must Reside in the SAME Household)

To pay $20 by Credit Card for Single Membership
please press the following button

Household Membership is $25

All Household Members must reside at the same location.

for more information write: John Coward

If you can't use forms feel free to Join the Adventure by downloading our
Membership Form and sending it on in with your payment.

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