USS Andrew Jackson Reunion
Sunday, October 21, 2018,
through Sunday, October 28, 2018

Registration Form


Registration

USS Andrew Jackson SSBN 619 Reunion

October 21-28, 2018

Holland America's Ship Nieuw Amsterdam
Sailing from Fort Lauderdale, Florida
(In conjunction with the USSVI National Convention)

 

Name___________________________________________________________________

 

Spouse or other attendee________________________________________________________________

 

Address: Street/P.O. Box________________________________________________________________

 

City:__________________________________State:_____________ Zip Code__________________

 

Phone Number:__________________________ 

 

Cell Phone Number (Probably one you’ll use while traveling to and from Fort Lauderdale)____________________

 

Email address___________________________________

 

 Please list Hotel and/or any other pertinent information if traveling to Fort Lauderdale.

____________________________________________________________________________________

 

____________________________________________________________________________________

 

Service Information

 

Crew:    Blue__________________ Gold_______________ No. Of Patrols_______________

 

Andrew Jackson service dates: From ______________to __________________

 

Rank/Rate____________________ Plank Owner: Yes_______ No _______

 

Other Boats_______________________________________________________________

_________________________________________________________________________

 

 

Registration Information

 

Registration: Cost Per Person: $20.00 for one, $30 for two of you.

 

Number coming to Reunion: _________ ,  Total_____________

Make checks out to: Jack McAllister, USS Andrew Jackson SSBN-619 Reunion

 

Mail to: Jack McAllister, 963 Harbor Town Dr., Venice, FL 34292-3127

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