Adams Class Naval Ship Museum
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:
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
– 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.
* Required information
* Name (First Middle Last):
* Mailing Address (St/Rd):
* Home Phone:
* Primary 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).
* 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
Duty Stations / Facilities & Locations: Mo/Day/Yr 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
number of ads; just ignore them - you DO NOT need to check any of the boxes except the (
) button to verify your data.
When you finish verifying your data and click (
), 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.