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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,
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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