APPLICATION AND GENERAL INFORMATION (year 2005)
                            USS RAMSEY ASSOCIATION
	      (Please print clearly and answer all information)                      

NAME:_______________________________________________________________

ADDRESS:____________________________________________________________

CITY:__________________________________STATE:_________ZIP:_____________
                                                                                                           
HOME PHONE:_________________________________      

WORK or CELL (circle one):_______________________________________

EMAIL ADDRESS:_______________________________________________________

Date of Birth: _______/_______/____________WIFE'S NAME:___________________
                         (mo.)       (day)        (year opt.)

CHECK ONE: (  ) SINGLE   (  ) MARRIED   (  ) SEPERATED   (  ) DIVORCED
           (  ) WIDOWER
       
                            USS RAMSEY INFORMATION                  
                               office use only
	
          (  ) 2003  (  ) 2004   (  ) 2005     (  ) 2006

Rank coming aboard:_____________ Month/Year:________________  

Rank Leaving:___________________Month/Year:________________  
     
Rank Leaving Navy:______________Month/Year:________________

Served when she was : DEG (  )  FFG (  ) Did you serve on a West Pac: (  ) yes (  )no

If yes which ones: West Pac#:________________________________
#1: 04/30/68-11/09/68        #2: 10/08/69-04/18/70
#3: 06/02/71-11/13/71        #4: 1972-1973 no cruise book
#5: 01/30/75-??/??/75        #6: 07/30/76-??/??/77
#7: ??/??/78-??/??/79        #8: ??/??/80-??/??/81
#9: ??/??/83-??/??/83        #10: ??/??/86-??/??/86            
#11: ??/??/87-??/??/??


Division: FIRST (WEAPONS) (  )       OI (OPERATIONS) (  )    
          SECOND (WEAPONS) (  )      M (ENGINEERING) (  )  
          THIRD (WEAPONS) (  )       R (ENGINEERING) (  )
          OC (OPERATIONS) (  )       S (SUPPLY) (  )                     
          OTHER:______________________________

Please answer the following questions and make checks payable to "Ramsey Assoc.".

(  ) Yes, I would like to ship over and join the Association again. This will entitle me to all newsletters and bulletins for the year 2005. I understand that the dues are $25.00  and that $5.00 of this money is being ear marked for the "Search and Find Team" to  help pay the expenses for finding shipmates that are still adrift.

(  ) Yes, I would like to join the Association for the first time. All the above information applies to my application.

(  ) No, I would not like to join the Ramsey Association at this time. I am sending in the general information sheet so that my name will be listed as being contacted.

(  ) No, I am not interested at all but am sending in the general information sheet so that my name will be listed as being contacted.

All information is kept confidential and will not be given out except to authorized Officers and members of the Association.

                             
Nick Previti                       Jim Robertson
Commander & Supply Officer         Executive Officer & Disbursing Officer
USS Ramsey Assoc.                  USS Ramsey Assoc.
RAMSEY2NEDIST@AOL.COM              JROBERTSON@HVC.RR.COM 
                                   CELL# 845-863-4646                                                 


                             Mail to: USS RAMSEY ASSOC.
                                      % NICK PREVITI
                                      6 BERRY LANE
                                      NEWBURGH, N.Y. 12550