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WAVES National Corporation STILL SOMETHING SPECIAL MEMBERSHIP APPLICATION Fiscal Year - 1 August to 31 July Mail your check $12.00 Gloria Farwell 7622 Orange Blossom Dr. Cupertino, CA 95014 Application Dace (Please Type or Print) NAME:_________________ Phone:_____________ First Middle(Maiden) Last (A/C) ADDRESS:_____________________________ Street City State Zip SERVICE NO:____BIRTHDAY____HUSBAND NAME:_____ ENTERED LEFT SERVICE:_____________ SERVICE:_______ Date Place Date Place RANK/RATE YEARS YEARS AT TERMINATION:__ACTIVE DUTY:__RESERVE DUTY:_ OCS/ TRAINING BOOT STATION:_________SCHOOLS:__________ DUTY STATIONS:_______________________________ DO YOU OBJECT TO ANY OF THE ABOVE INFORMATION BEING PRINTED IN ROSTER?_______ IF ANY, SPECIFY WHICH ITEMS: MEMBERSHIP (check one): NEW__ RENEWAL__ MEMBERSHIP APPLICATION (Please Print) NO:_____ BAY AREA W A V E S OF NORTH CALIFORNIA DATE___________ NAME_________________ Phone_____________ FIRST MIDDLE MAIDEN LAST AREA CODE ADDRESS___________________________________ STREET CITY STATE ZIP ____________BIRTHDAY______ANNIVERSARY________ SOCIAL SECURITY NUMBER - I.D. NUMBER ENLISTED_____________ DISCHARGED_______ Date Place Date Place RANK/RATE___YRS ACTIVE DUTY____RESERVE DUTY__ BOOT STATION_________DUTY STATIONS__________ EXPERIENCES CHAIRMANSHIP/HOBBIES__________________ NATIONAL BAY AREA WAVE DUES__37.00___ W A V E S DUE_35.00_ AM'T - DATE PD AM'T - DATE P