Registration Form

USS Magoffin Association

NAME:__________________________________________

ADDRESS:_______________________________________

CITY:_____________________STATE:_______ZIP:______

PHONE: (_____)_______________

EMAIL:__________________________________________

SIGNIFICANT OTHER:_____________________________

DATES SERVED ABOARD THE MAGOFFIN:

FROM__________ TO__________

RATING/RANK__________________DIVISION__________

I am a new member, my 2006 dues ($10) are enclosed [ ]

My 2007 dues ($10) are enclosed [ ]

My 2008 dues ($10) are enclosed [ }

My 2006 dues ($10) are enclosed [ ]

Please mail this form and your payment to:

USS Magoffin Association

Joe Beninato, Treasurer

61 Sunrise Drive

Edison, NJ 08817

Please make payment by check or money order. Always make payable to USS Magoffin Association. NOTE: Use your browsers print command, this should print out the dues form.