~ USS Buchanan (DDG-14) Association ~

Membership Application

Please fill out and return this application with a check for $14.00,
made out to the USS Buchanan Association.

Please send the check and application to

Dick Zimmermann
2000 S. Eads #329
Arlington, VA 22202

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Date:__________________

Name:_________________________________

Address:_______________________________

City:___________________________   State:______   Zip Code:_____________

Phone Number: (       )____________________________

E-Mail (if available):_______________________________

Specify Regular or Associate Membership:_____________________

Years you served aboard Buchanan:

       First tour:______ to_______     Second tour (If applicable):______ to_______

Highest rank aboard Buchanan:_____________

Do you wish to serve on any Association committees?:_______

Do you have any specific skills to lend the Association?

       Please state:_________________

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For Official Use Only
Date received by Treasurer:______________                   Initials:_________

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