So that we might keep our records current:

• Please provide us the following information:

  Your first name
  Last name
  Your birthday (month/day)
  Spouse's first name
  Spouse's birthday (month/day)

• If applicable, please provide us your change of address:

  Street Address
  Address 2
  City
  State
  Zip

• If not currently assigned, indicate those activities in which you would be willing to assist:
  

  Programs	Membership and Retention
  Education	Sea Cadets
  Ship Visits	Newsletter
  Web Site	Active Duty Liaison, USN
  Photography	Active Duty Liaison, USCG
  Active Duty Liaison, USMC	Merchant Marine Liaison
  Sea Services Recognition	Community Affiliate Liaison
  Recruiting and Reserve Liaison, USMC

• Please provide the following contact information:

  Work Phone
  Home Phone
  FAX
  E-mail