Submariners’ Association Of Canada (East)

                            PO Box 91, Dartmouth, NS. B2Y 3Y2

            MEMBERSHIP APPLICATION FORM

 

Name in Full………………………………………………………………………………………………….

 

Nickname…………………………………                    Date of Birth:…………………………………..

Mailing Address……………………………………………………………………………………………….

…………………………………………………………………………Postal Code……………………….

Phone…………………………………………               Email:……………………………………….

Spouse / Partner Name (If Applicable):……………………………………..

SERVICE INFORMATION

Navy in which served:  RCN………….  RN………… ..CAF(N)…………….Other*……………

*If other state which………………………………………………………………………………..

Date(s) of entry:……………….. . ……………………………………………………………...….

Date(s) of Discharge:……………………………………………… Currently Serving:…………..

Official / Service number:…………………………………………………………….. Rank:………………………… Trade:…………………………… Specialty……………………..

Awards / Decorations…………………………………………………………………………………….

Date qualified in submarines…………………………………………………………………..

Submarine in which qualified…………………………………………………………………..

 

SUBMARINES SERVED IN:

NAME

DATE

NAME

DATE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SIGNATURE OF APPLICANT:………………………………. DATE…………………………

 

Dues: $ 20.00.

MAKE CHECKS PAYABLE TO: SUBMARINERS’ASSOCIATION OF CANADA (EAST)
 

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