Member Update Form

Please fill in the following form to update your address and share your latest news.

If you experience any difficulties viewing this form, you may E-mail your address and other information directly to Rusty Phelan, Secretary.

First Name:  

Last Name:  

Maiden Name (if applicable) 

UNC Class:   or Staff (Years in the format of 19XX-19XX)

Current Status:
 Active Duty      Reserves      Civilian      Retired Civilian
Retired Military (Active)      Retired Military (Reserves)

Current Rank (or highest rank held):  

Branch of Service (when commissioned):   US Navy US Marines USNR USMCR

Command:  

Billet:  

 
Civilian Occupation

Business Name: 

Position: 

 
Home and Personal Information

Spouse's Name:

Home Address:

Address 2:

City: 

State: 

Zip:  

E-mail:

Phone:

Home:

Work:

Fax:

Please check if this is an updated home address: 

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Additional comments or other announcements:

Thank you for your information!