Adams Class Veterans Association, Inc. (ACVA, Inc.)
ACVA Membership Form                                        Revised - Feb. 8, 2010

Anyone supporting our mission can be a member & are not required to have been in the military.

No Dues are required, but if you would like to make a Donation, $25 or more will make you an ACVA Member and Plankowner. We have two payment options:

CHECKS should be made out to "ACVA, Inc." and sent to:
          ACVA Executive Secretary
          c/o Dave Myerly
          5 Bush Road
          Denville, New Jersey 07834-2906

CREDIT CARDS – Go to left column of this page.
          Click on “Make a Donation.” You may choose Visa or Master Card.
          Complete all information and click submit.

   IF YOU WORK FOR A COMPANY HAVING A MATCHING GIFT PROGRAM: PLEASE OBTAIN THE FORM, COMPLETE YOUR PART, SIGN AND SEND WITH YOUR CHECK. NOTIFY ME THE MATCHING GIFT FORM IS ON THE WAY. SOME COMPANIES ALLOW YOU TO MAKE A MATCHING GIFT UP TO A YEAR AFTER A DONATION HAS BEEN MADE.

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* Required information

* Name (First Middle Last):     

* Mailing Address (St/Rd):    

* City/State/Zip:  

* Home Phone:   Fax: 

* Primary E-mail:  

Secondary E-mail:  

PLEASE REMEMBER TO SEND ME AN UPDATE IF YOU CHANGE EMAILS

*Please indicate your preference(s) and place X next to each statement that applies: (1 X ) ( 2 X) etc.

1.    Not directly involved.                    2.    Participate in online discussions.  

3.    Assist with special projects.      4.    Like to serve on the board (send short resume).  

Comments:


* If you served in the military please complete the following fields.

Rank & Rate at Discharge:     

Date You Left Service (Mo/Day/Yr):     

For the following - Please list Oldest to Most Current. Place additional info under Comments

Ship(s) Name(s) and Hull #:                                                                                                          Mo/Day/Yr From / To

1. USS:      From:      To:  

2. USS:      From:      To:  

3. USS:      From:      To:  

Other Assignments:
Duty Stations / Facilities & Locations:                                                                                       Mo/Day/Yr From / To

      From:      To:  

      From:      To:  

Please use the Comments section to list information if you served on more ships or duty stations.

PLEASE READ THIS: When you submit this form, you will be taken to a verification page, where you can check the information you have submitted. You will also see a large number of ads; just ignore them - you DO NOT need to check any of the boxes except the (continue) button to verify your data.

When you finish verifying your data and click (continue), you will probably be assaulted by more ads but eventually you wil be able to go back to the main ACVA page.


© 2004-2011 Adams Class Veterans Association, Inc.