Member Name: .. Spouse/Guest Name

Names to print on Reunion Badges if different than above:

Email Address:

Year(s) aboard the Gal: .... Rating/Rank

Address: Street Apt#

City , State , Zip

... Phone:

** To ensure transparency assigned 50/50 Ticket numbers will be listed on website and physical tickets
will be inventoried and audited by a shipmate committee both before and after the drawing.

make check payable to USS Galveston Shipmates Association and mail TO:

Bob Bakos 
2826 Custer Ave
Pittsburgh, PA 15227