USS Enterprise CVAN/CVN-65 Association Membership Form 
                                             Fields Indicated in RED are REQUIRED Fields
 Submission Type                  
  Membership Number (current members only)   


First        Initial       Last      Nickname  

 Spouse            

Street    City     

State      Country     Zip/Post  

Phone     Cell      

Email    
  
Enterprise OnBoard Information
Rank/Rate           Command         

Department         Division   

Years On Board  
(Enter years with comma between  ex: 74,78,77-79,)

Recruited By :

Membership Type:
           
Dues(Number of Years and Payment Method --Note New Member requirements)                      
         
      
        
         
(NOTE: Returning members after an absence must renew as a New  Member)
Form Of Payment:                                                                       
                     
                                                             
   Print the form for your records then press submit