USS THOMAS C. HART (DE/FF-1092) VETERANS ASSOCIATION

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USS THOMAS C. HART (DE/FF-1092) VETERANS ASSOCIATION MEMBERSHIP FORM 
(This form should print for you when you click your printer function - Please print the form, complete, and mail to address listed on the form,

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If a shipmate told you about the TCHVA, please tell us his name:____________________ 


First Name _______________________ M.I. ____ Last Name _______________________ 

Rate/ Rank on TCH _____________________    Division _____________________
 

Year Reported Aboard_____________  Year Detached________________________
 

Street Address: _____________________________________________________________
 

City_______________________________________ State_______ Zip ________________
 

Home Phone _________________________ Cell/Work Phone_______________________
 

Spouse Name: ________________________________________
 

Current Email Address: _____________________________________________________
 

Dues are only $10 per year. We have chosen to collect for two years($20) at a time to reduce the administrative burden on our all volunteer staff.  Thanks for your understanding and support.  You may join for any additional years if you desire.

 I am sending in $___________.  Please begin/renew my membership!

Please mail check/M.O. to: 
USS THOMAS C. HART VETERANS ASSOCIATION
                                                    c/o Randy Groen
                                                      2219 Friendship Ln.
                                                      Burnsville, MN 55337
                                                 “YA GOTTA HAVE HART”

NOTE:  IF YOU HAVE DIFFICULTY PRINTING FORM, PLEASE JUST WRITE INFO ON SHORT NOTE AND INCLUDE WITH YOUR PAYMENT!  WE'LL MAKE SURE WE MUSTER YOU IN!  THANKS
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USS Thomas C Hart (FF 1092)