Back To The Ladies Auxiliary Page
Please print this form and fill in the information Membership fee: $5.00 per year - Jan through Dec |
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| First Name | ______________________________ |
| Last Name | ______________________________ |
| Street Address | ______________________________ |
| City | ______________________________ |
| State/Province | ______________________________ |
| Zip/Postal Code | ______________________________ |
| Husband's Name | ______________________________ |
| Ship Name | ______________________________ |
| Ship Number | ______________________________ |
| Home Phone | ______________________________ |
| Work Phone | ______________________________ |
| Email Address | ______________________________ |
| Webpage URL | ______________________________ |
Did someone tell you about About/Encouraged You to Join DESA Ladies Auxiliary? If yes, please tell us their name: _____________________________________________ |
Mail this form and $5.00 membership fee to: Ladies Auxiliary, DESA Thank You and Welcome Aboard! |