Is this a gift membership? Yes_____ No_____
MEMBER INFORMATION
Title:	___Mr. ___Mrs. ___Ms. ___Mr. & Mrs. ___Other_________________
Name:	_____________________________
Address:	_____________________________
City:	_____________________________
State:	_____________________________
Zip:	_____________
Phone:	_____________________________
Email:	_____________________________
	WWII Veteran___	Retired Military___
	Active Duty Military___
YOUR INFORMATION
Title:	___Mr. ___Mrs. ___Ms. ___Mr. & Mrs. ___Other_________________
Name:	_____________________________
Address:	_____________________________
City:	_____________________________
State:	_____________________________
Zip:	_____________
Phone:	_____________________________
Email:	_____________________________
	WWII Veteran ___
I authorize the Admiral Nimitz Foundation to charge my payment against my credit card.
Type of card:	___ Visa ___ MasterCard
Card Number:	____ - ____ - ____ - ____
Expiration Date:	____________________

Choose a Membership Category:

___ $30 Patriot	___ $250 Patron
___ $50 Advisor	___ $500 Admiral's Circle
___ $100 Skipper	___ $1000 Benefactor

Please Print and Mail to:
Ms. Marty Kaderli
Admiral Nimitz Foundation
328 East Main
Fredericksburg TX 78624