SAM RAYBURN CREW MEMBER DATA SHEET
To Become Entered Into The Crew
Member Database
Please Provide All the Data Asked For And Return To:
USS Sam Rayburn (SSBN 635) Crew Member Data Sheet
NOTE: THIS INFORMATION IS PRIVATE, TREATED CONFIDENTIALLY AND ONLY SHARED WITH SAM RAYBURN SHIPMATES. Categories marked with an * are included in the database, not published in the Directory but can be provided on request. Contact the SAM RAYBURN Data keeper thunder1948@comcast.net with any questions.
Full Name (Last, First & Middle initial):
Nickname*:
Wife’s Name (as applicable):
Postal /Street Address:
Postal Address line 2:
Location* (RR & PO Box holders):
City, State & ZIP code:
Home Phone:
Optional phone*:
Enter data as XXX-XXX-XXXX and indicate Work, Cell or Fax as applicable.
Primary E-Mail Address:
Secondary or work E-Mail Address:
Arrived aboard (i.e. January 1964):
Detached (i.e. January 1965):
Crew (Blue, Gold, Overhaul, Commiss, Decommiss., MTS conversion):
Rank/Rate when detached [i.e. ETCM, LT, etc.; (SS) if qualified]:
Division/ Position on Board (i.e. Machinery, Auxiliary, Radio, COB, WEPS, XO, Nav Center Supervisor, etc.):
*If Retired Military; Rank/Rate, and Branch:
*REMARKS (Alternate addresses, Additional tours aboard, or Special Recognition received):
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Please send completed worksheets to the SAM RAYBURN Database Manager. If using E-mail, first save a copy to disk, and then click the following link. -mailto:thunder1948@comcast.net Your EMAIL program will open, insert the completed work sheet into the pre-addressed message; and send it on its way. To forward by Postal Mail; print a copy of this worksheet with all margins set to less than ½”, fill in the blanks and mail it to: Stan Feinberg 11 Day Road Ashland, MA 01721-2028 If you know of another Rayburn shipmate that isn’t listed, please give him a blank copy of this worksheet to submit; or else furnish their Name and Postal/ Email address so they may be contacted and then added to the database. Rev 8/28/2007 |