USS Yosemite Association Online Membership Application Form

Online Membership Application Form

After completing this form, please mail a check with either the Life Time Member Fee or the annual $15 subscription to:
USS Yosemite Association
Alan Koepke
His mailing address:
881 Boundary Blve
Rotonda West, FL 33947
Cell: (920) 960-8579 Email: ajkoepke1@gmail.com

Name*
First Last
Spouse
Phone*
Email*
Enter Email Confirm Email
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Member of US Navy Memorial?*
- Yes
- No
Date of Birth*
dd/mm/yyyy
DD slash MM slash YYYY
Information: Onboard the USS Yosemite and Military
Interval Onboard the USS Yosemite*
dd/mm/yyyy
From: To:
Your Rank/Rate while onboard*
USS Yosemite Division*
Military Service Dates - Start and End Dates*
dd/mm/yyyy
From: To:
Total Length of Military Service*
Final Military Rank/Rate at Discharge or Retirement*
Any Additional Information:
Membership Fee*
- Yes - I want pay $15 every year
- No -I want to pay one-time with a Lifetime Member Fee
Membership is either a one-time Lifetime Fee or an Annual Subscription Fee
Life Time Member Fee*
- Age 25-29 --- $335
- Age 30 -34 ---$307
- Age 35-39 --- $280
- Age 40- 44 --- $252
- Age 45-49 --- $225
- Age 50-54 --- $197
- Age 55-59 --- $170
- Age 60-64 --- $142
- Age 65-69 --- $115
- Age 70-74 --- $87
- Age 75-79 --- $60
- Age 80-84 --- $32
- Age 85 & UP --- $15
You Selected the $15 Subscription Membership
Please send a check for the amount of $15 for the annual membership fee. Please Make Check PAYABLE TO USS YOSEMITE ASSOCIATION.
Alan Koepke
His mailing address:
881 Boundary Blve
Rotonda West, FL 33947
You Selected the Life-Time Membership
Please send a check for the amount that corresponds to your age for the Life Time Member Fee. Please Make Check PAYABLE TO USS YOSEMITE ASSOCIATION.
Alan Koepke
His mailing address:
881 Boundary Blve
Rotonda West, FL
33947
Please Note:
Membership Processing requires your check to be received by Alan Koepke before we can finalize your membership.

Alan may be reached by his cell: (920) 960-8579 or Email: ajkoepke1@gmail.com
I Acknowledge that my Check for the Membership Fee must be Received by Allan Koepke to complete the Membership Process.*
- I acknowledge
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