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

First Name: � � Middle Initial: Last Name: Rank:   Department: Civilian Military Address: City: 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) Name                   Rank           Dept.                     Birthday ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________

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. Back to Main Bridge