Name of Donor: ________________________________________Life Member #________

Street Address:_____________________________________________________________

City/Town: __________________________________________________________________

State:____________________________________ Zip Code:_______________-__________

Submarine to be shown on card: _______________________________________________

Configuration requested: _________________________________***

***Since many boats were modified over their existence you may prefer to specify which configuration the boat was in during your on-board status (i.e. Guppy 1, Guppy 2, Guppy 3 AG, AR etc) an attempt will be made to provide the appropriate picture on your card.

Amount Enclosed $ ____________________(min $50.00) If you desire to upgrade to life member at the same time please add the appropriate Life Member fee for your age group. Contact the National office for assistance in determining this additional fee.

Please make checks payable to:   US Submarine Veterans' Charitable Foundation

In the memo portion of the check: General Fund

Mail To:

USSVCF- General Fund
P.O. BOX 3870
Silverdale, WA 98383-3870

Please include this form with your donation.

Thank you for your interest and support of this program.

CFL-2 (2002)