This section contains your name and discharge or retirement date. If you are still active,
leave the discharge/retirement box empty and so indicate with the checkbox.

Your Name	First: MI: Last:
Discharge/Retirement Date:	- Month - January Febuary March April May June July August September October November December - Year - 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010
Still On Active Duty:

This section contains your on board duty tour(s) information. Up to three tours may be entered.
If you served more than three tours on board, please contact the Webmaster with the additional information.

	1st Tour	2nd Tour	3rd Tour
Tour Dates:	- Month - January Febuary March April May June July August September October November December - Year - 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992	- Month - January Febuary March April May June July August September October November December - Year - 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992	- Month - January Febuary March April May June July August September October November December - Year - 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992
	to	to	to
	- Month - January Febuary March April May June July August September October November December - Year - 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992	- Month - January Febuary March April May June July August September October November December - Year - 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992	- Month - January Febuary March April May June July August September October November December - Year - 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992
Rank/Rate: (i.e., Capt, LCDR, RD2, BM1, SN, etc.) (Highest rank or rate during each tour)
Division(s) (i.e., B, E, 1st, OI)

This section is intended for the NATO Mixed Manning Demonstration crew. If you served onboard between
June 1964 and December 1965 or any portion thereof then you are considered part of the MMD.
If you were a member of the MMD crew and your name is not included in the Mixed Manning pages,
please notify the Webmaster and, if possible, include a photograph of yourself during your time on board.

NATO Mixed Manned Crew? (Jun '64 to Dec '65)?	Yes: No:
Country:	GermanyGreeceItalyNetherlandsTurkeyUnited KingdomUnited StatesNot listed

If you served on any other DDG-2 class ships, please check any you served on (note that
USS Biddle/USS Claude V. Ricketts has already been checked for you):

USS Charles F. Adams DDG-2 USS John King DDG-3 USS Lawrence DDG-4 USS Biddle/USS Claude V. Ricketts DDG-5 USS Barney DDG-6 USS Henry B. Wilson DDG-7 USS Lynde McCormick DDG-8 USS Towers DDG-9 USS Sampson DDG-10 USS Sellers DDG-11 USS Robison DDG-12 USS Hoel DDG-13 USS Buchanan DDG-14 USS Berkeley DDG-15 USS Joseph Strauss DDG-16 USS Conyngham DDG-17 USS Semmes DDG-18 USS Tattnall DDG-19 USS Goldsborough DDG-20 USS Cochrane DDG-21 USS Benjamin Staddert DDG-22 USS Richard E. Byrd DDG-23 USS Waddell DDG-24

The following information is kept in strict confidentiality.

Your Date of Birth:	- Month - January Febuary March April May June July August September October November December - Day - 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 - Year - 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 1937 1936 1935 1934 1933 1932 1931 1930 1929 1928 1927 1926 1925 1924 1923 1922 1921 1920 1919 1918 1917 1916 1915 1914 1913 1912 1911 1910 1909 1908 1907 1906 1905 1904 1903 1902 1901 1900
Email address:
Spouse/SO Name:	First: MI: Last:
Spouse/SO Date of Birth:	- Month - January Febuary March April May June July August September October November December - Day - 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 - Year - 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 1937 1936 1935 1934 1933 1932 1931 1930 1929 1928 1927 1926 1925 1924 1923 1922 1921 1920 1919 1918 1917 1916 1915 1914 1913 1912 1911 1910 1909 1908 1907 1906 1905 1904 1903 1902 1901 1900
Address 1:
Address 2:
City:
State (if not US, enter country):
Zip/postal code:
Home phone:
Cell phone:

Your username/password will automatically register you for The Big Nickel Forums, allow you to modify
your information and allow you to contact other shipmates through the site.

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Password (minimum 6 characters):

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