~ 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:_________

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