USS Mauna Kea AE-22 Reunions
4699 N. Shorebrooke Ave., Tucson AZ 85705  Phone – 520-395-1780
Website:  www.ussmaunakeaae22.com or ussmaunakeaae-22.com

USS MAUNA KEA AE-22

REUNIONS 
11TH Annual Shipmates Reunion Membership Form
May 4 – 7, 2017

Name____________________________________________________________________________________________________________________________________

Date______________________________________________________________________________________________________________________________________

Address__________________________________________________________________________________________________________________________________

City______________________________  State____________  Zip_____________

Phone (Home)__________________________________________                           (Cell)__________________________________________________________

Email address____________________________________________________________________________________________________________________________

Spouse / Partner _________________________________________________________________________________________________________________________                                      
                                     Will be used for reunion guest list, name badges, etc.,

Birthday (you do not need to include year)__________________________________________________________________________________________
 

Dates served on Mauna Kea (yrs. only) ______________________________________________________________________________________________

Rate/Rank_________________________________________________________________________________________________________________________________

The fees are as follows:  $10 single/annual membership.  You may pay for multiple years with one check. 

Specify the years (i.e. 2016, 2017) you are paying for.

MEMBERSHIP TYPE  _________Single/Annual   __________________Multiple Yrs.   _____________New   _________Renewal

 

                                                *** Please make checks payable to USS MAUNA KEA Reunions***

 

Mail payments to:
Richard “Dick” States
USS Mauna Kea AE-22 Reunions
4699 N. Shorebrooke Ave., Tucson AZ  85705-7105