~ USS Buchanan (DDG-14) Association ~
Membership Application
Please fill out and return this application with a check for
$14.00 for one year membership or $140 for lifetime membership, made out to Lou
Proctor.
Please send the check and application to
Lou Proctor
110 Shore Circle
Plattsburg, MO 64477-9518
Date:__________________
Name:_________________________________
Address:_______________________________
City:___________________________ State:______ Zip Code:_____________
Phone Number: (       )____________________________
E-Mail (if available):_______________________________
Specify Regular or Associate Membership:_____________________
Years you served aboard Buchanan:
First tour:______ to_______
  Second tour (If applicable):______ to_______
Highest rank aboard Buchanan:_____________
Do you wish to serve on any Association committees?:_______
Do you have any specific skills to lend the Association?
Please state:_________________
For Official Use Only
Date received by Treasurer:______________
                 
Initials:_________
Back to
Buchanan Home Page