USS Belknap DLG/CG-26 Association
Online Registration/Update Form

Whether this is a new registration or an update to your record, Please fill out the form completely to provide the contact information for the online logbook and the association secretary's file:

Use your TAB key to advance through the form. Your ENTER key will send it.

First Name:
Last Name:
Rank/Rate while onboard:
Dates served Onboard: (example: Jan68-Nov70)
Highest Rank/Rate Held:
Retirement/Discharge Date:
Need password reminder:
E-mail address:
The following entries will NOT be published:	: And will NEVER be given out
Will be used to maintain our shipmate list:	: Only in  our secretary's files!
Street Address:
Address (cont.) (Apt#):
City:
State:
Zip Code:
Home Phone:
Spouse Name:
What Dept/Div were you in?

                    (this form was last updated 19 Nov. 2011)