Adams Class Veterans Association, Inc. (ACVA, Inc.)
Membership Form
Revised - Feb. 1, 2008

Anyone supporting our mission can be a member & persons are not required to have been in the military.

No Dues At This Time
Persons sending a completed ACVA Member Application with a Donation Check of $25 or more will become ACVA Members and an ACVA Plankowner

NOTE: Dave has been overwhelmed with membership applications since Jacksonville endorsed the project. He is processing them as fast as he can, please be patient.

Checks should be made out to "The ACVA, Inc." and sent to:
ACVA Executive Secretary
c/o Dave Myerly
5 Bush Road
Denville, New Jersey 07834-2906

IF YOUR COMPANY HAS A MATCHING GIFT PROGRAM: PLEASE GET THE FORM, COMPLETE YOUR PART, SIGN AND SEND ALONG WITH YOUR CHECK. NOTIFY ME THE MATCHING GIFT FORM IS ON THE WAY.
SOME COMPANIES ALLOW USE OF A MATCHING GIFT FOR UP TO A YEAR AFTER A DONATION HAS BEEN MADE.

---

* Required information

* Name (First Middle Last):     

* Mailing Address (St/Rd):    

* City/State/Zip:  

* Home Phone:   Fax: 

* Primary E-mail:  

Secondary E-mail:  

REMEMBER TO SEND ME AN UPDATE IF YOU CHANGE EMAIL ADDRESSES

*Would you like to help achieve our goals? Indicate your preference(s) and place X before the appropriate statement(s): (1 X ) ( 2 X) etc.

1.    Not directly involved.                    2.    Participate in online discussions.  

3.    Assist with special projects.      4.    Like to serve on the board (send resume).  

Comments:


* If you served in the military please complete the following fields.

Rank & Rate at Discharge:     

Date You Left Service (Mo/Day/Yr):     

Ship(s) Name(s) and Hull #:                                                                  On Ship

1. USS:      From:      To:  

2. USS:      From:      To:  

3. USS:      From:      To:  

Other Assignments:
Facility/Location:                                                                                       Dates

      From:      To:  

      From:      To:  

Please use the Comments section to list information if you served on more ships or duty stations.

PLEASE READ THIS: When you submit this form, you will be taken to a verification page, where you can check the information you have submitted. You will also see a large number of ads; just ignore them - you DO NOT need to check any of the boxes except the (continue) button to verify your data.

When you finish verifying your data and click (continue), you will probably be assaulted by more ads but eventually you wil be able to go back to the main ACVA page.