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                                       FLEET RESERVE ASSOCIATION
                                       125-N. WEST STREET
                                       ALEXANDRIA, VA. 22314-2754

                MAKE CHECKS AND MONEY ORDERS PAYABLE TO THE

                                    FLEET RESERVE ASSOCIATION.             

                     MEMBERSHIP APPLICATION  -  SAN MIGUEL BRANCH 367

 I certify that I fulfill all eligibility requirements, and want to join the FRA.

NAME: __________________________________________________________________RATE/RANK: ______________

ADDRESS: _________________________________________________________________________________________

DATE OF BIRTH: _____________________SSN: _______________________PHONE: _(_______)________________

SERVICE: ____________STATUS: _____________ MEMBERSHIP PREFERENCE BRANCH NO:  
 367

PREVIOUS FRA MEMBER?       YES      NO       IF YES, PREVIOUS MEMBER NO: __________________________

RECRUITED BY: _______________________________MEMBER NO: ___________________BRANCH: __________

SPOUSE'S NAME: _____________________________YOUR E-MAIL ADDRESS: ____________________________

APPLICANT'S SIGNATURE: ________________________________________________DATE: __________________

DUES: (CIRCLE)        1 YEAR - $30.00         2 YEARS - $57.00           3 YEARS - $85.00           5 YEARS - $135.00
                                               (note: New Members - Two year membership - $48.00)   

PAYMENT OPTIONS: (CIRCLE)       M.C.        VISA          DISCOVER       AMER. EXP.         CHECK OR MONEY
                                                                                                                                                          ORDER ENCLOSED
CREDIT CARD NO ________________________________________________________

EXP DATE ________________________________________________________________

SIGNATURE ______________________________________________________________



        
                                          
Thank you, SHIPMATE, for joining SAN MIGUEL BRANCH 367 -
"The Hardest Working Little Branch in Asia"
Contact us, and let us know you've joined our family.