Type of membership

Individual Family Apprentice/Sea Scout

Active Membership

Name (First, MI, Last): A value is required. A value is required.

Mailing Address: A value is required.

City, State, Zip: , A value is required. A value is required. - A value is required.Invalid format.

Telephone Home A value is required.Invalid format. Work

E-mail A value is required.Invalid format.

Gender Male Female   Birth Date A value is required.Invalid format.A value is required.Invalid format. Spouse's Name

Additional Active Members

(Add another adult from the same household if applying for an Individual Active Membership with Family)

Name (First, MI, Last):

Telephone Home Work

E-mail Invalid format.

Gender Male Female    Birth Date A value is required.Please enter date format mm/dd/yy.

Family Members

(Add other adults/children from the same household if applying for an Individual Active Membership with Family)

Name (F, I, L): Birth Date Male Female

Name (F, I, L): Birth Date Male Female

Name (F, I, L): Birth Date Male Female

Apprentice or Sea Scout Application

Check one Apprentice Sea Scout

Name (First, MI, Last):

Mailing Address:

City, State, Zip: , -

Telephone Home E-mail

Birth Date Male Female

Personal Skills

Boating Experience

Being a boat owner is not a membership requirement; however, if you do own a boat we would be interested in knowing if its a Power or Sail (check one).

The name of your boat and the overall length of your boat .

Which USPS member most influenced you to join our Organization?

USPS Member Name Certificate Number (if known)