P.O. Box 126158 Fort Worth, TX 76126 - 0158

2018 MEMBERSHIP APPLICATION / UPDATE / RENEWAL

Please provide the following information to ensure we can maintain contact

Member [Last, First, MI] Nickname

Spouse [Last, First, MI] Nickname

Address Apt/Suite #

City State Zip -

Phone(s): H C E-mail

Facebook Name Website

Executive Council Position(s) and Dates

B-58 Job Description(s) and Dates

Dependent(s) who desire to become Members or a Friend for a Backup Contact

Contact [Last, First, MI] Relationship

Address Apt/Suite #

City State Zip -

Phone(s): H C E-mail

Contact [Last, First, MI] Relationship

Address Apt/Suite #

City State Zip -

Phone(s): H C E-mail

Contact [Last, First, MI] Relationship

Address Apt/Suite #

City State Zip -

Phone(s): H C E-mail

Keep Your Membership Current

Paid-Up-for-Life (PUFL) B-58 Hustler Association Member, widow, or dependant

No Payment Due!

NOT a Paid-Up-for-Life B-58 Hustler Member or Individuals who were NOT associated with the B-58 Hustler Program, but truly admire the first Mach 2 Supersonic Bomber and would like to join the B-58 Hustler Association with full privileges.

Include a $10.00 Check for Two-Year Dues Payment!

Or, determine Paid-Up-for-Life (PUFL) Dues Payment:

Under Age 59: $50.00 Age 60–69: $40.00 Age 70 and Older: $20.00

Current Age . A $ . Check is included for PUFL Dues Payment

Personal Biography

Include: (1) your full name; birthplace; and names of your parents, siblings, spouse(s), and dependents; (2) pre-adult schooling; (3) pre-B-58 employment positions, affiliation(s) with the B-58 Program, and post-employment positions; (4) all associated education, and training; as well as career and life experiences and accomplishments during your working and retirement years; (5) dates and necessary details to describe these pertinent events which made you who you are today; and (6) pictures for an even greater understanding of your life journey. Add additional pages as needed! Our biographies will be published in the Personnel History pages of our Association website (