The information that you provide below is going to go into a database. This
database will be posted on
our web site,which means it will be available to
anyone that visits our site. IF YOU JUST WANT THE CLUB TO HAVE
THIS INFORMATION PLEASE STATE YOUR WISHES IN THE
COMMENT SECTION
. In doing so your information will remain private
available only to the officers of the club. If you prefer not to fill out this
form on the Internet please print it out and mail to:  
Andy Ragan, 10175
South Avenue EXT
, Poland, Ohio  44514-3454
Please Note:  All information you enter will be saved for the web site should you
decide to join our fine club. Dues are $15.00 per year. Please consider joining. It's a
great way to rekindle friendships with old (yes we're old now) shipmates.         
Thank you, Charlie
LAST NAME:
FIRST NAME:
STREET ADDRESS:
CITY:
STATE:
ZIP CODE:
Your email address:
Your phone number:
THE YEAR YOU REPORTED
ABOARD THE STRIBLING:
THE YEAR YOU DEPARTED:
IF YOU ARE RETIRED FROM THE SERVICE, YOUR RANK/RATE AT RETIREMENT:
YOUR RANK(S)/RATES WHILE
ABOARD THE STRIBLING:
THE FIRST NAME OF YOUR SPOUSE
or SIGNIFICANT OTHER:
How did you find us?
Comments: