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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