Membership Form (New or Update)

Join Today!
Become a member of the USS Springfield Bluejackets! Simply fill out and submit the form below. (paid Membership is appreciated, but not mandatory.). *- required fields

First Name*

Last Name*

Spouse

Address*

City*

State/Province*

Zip/Postal Code*

Country*

Home Phone # *

Cell Phone #:

Email Address*

Shipmate?

Ship

Aboard From*

Division*

Rating*

Plank Owner?

Deceased?

Home Town*

State/Provence*

Birthday

Type of Membership (Dues paid Sept thru Dec are good for the following year as well)

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