Name:__________________________ Rank/Rate_______ Years aboard____________

Spouse/Guest Name:_____________________________________________________

Address:__________________________________________ City:______________ State:____ Zip:______

Tel. No.________________________ EMAIL ADDRESS ________________________________________

Registration fee $70.00/per person X ( ) Total : $__________________

Association dues 2007/2009 ( If not yet paid ) ($25.00) $_________________

Total enclosed (*check or money order please, no cash ) $__________________
*Checks should be made payable to U.S.S Goodrich Assoc.

Current member____ New Member____ (check one)

Will you be staying at the Comfort Inn Hotel? Yes _____ No_____

If you would like to volunteer your help during the reunion, please check the area (s) you would like to assist us in:

Registration_____ Hospitality Room_____ Ship’s Store Sales_____

For additional comments or names, please use the back of this form.