USS LST Ship Memorial - Membership Form

(for a printable PDF of this form, please Click Here)

USS LST Ship Memorial, Inc. Membership Application
Please check box for Membership Level desired:

Membership Level	Amount
Seaman/Fireman 3 Year Membership	$20.00 per year $50.00 for 3 years
Chief	$100.00 per year
Executive Officer	$250.00 per year

Lifetime Memberships
Honorary Captain	$500.00 (Lifetime)
Honorary Admiral	$1000.00 (Lifetime)

Please type or print clearly:

Name:

Address:

City: ST: Zip:

Telephone: Email:

If you want a certain LST noted on your membership card, place ship number here:________________
If you care to, please use the back of this form to tell us why you support the LST (not required)

Membership Benefits:

Seaman/Fireman	Newsletter and 10% discount in the Ship's Store
Chief	Newsletter, 10% discount in the Ship's Store and free admission to the ship
XO and Captain	Newsletter, 10% discount in the Ship's Store, free admission to the ship, and an Executive Officer or Captain's Certificate suitable for framing
Admiral	Newsletter, 20% discount in the Ship's Store, free admission to the ship, Admiral's Certificate suitable for framing and lapel pin

Please print and fill out this form, make your check payable to: USS LST Ship Memorial, Inc. and mail to:

USS LST Ship Memorial, Inc.
840 LST Drive
Evansville, IN 47713 Office: 812-435-8678
Fax: 812-435-8678

(a 501-c-3 and 509 non-profit organization)

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