Military Officers Association of America
Southern Maine Chapter
Membership Application Form
I wish to make application for Membership in the Southern Maine Chapter of MOAA
Date: ______/______/______
Name: ____________________________________________________________________________________
Spouse’s Name: __________________________________________________________________________
Rank: ______________________________ Service: _________________________
Active Duty/ Retired/ Former Officer/ Widow(er) (please circle/underline one)
Regular/ Reserve/ National Guard (please circle/underline one)
Mailing Address:
_______________________________________________________________________________________________________________
(Street/PO Box) (City/Town) (State) (Zip Code)
Telephone number: ______________________________ Email: _______________________________________ .
National MOAA Card No. (note 1): ________________________________________________________________ .
Birthdate (optional): ____________________________________________________________ .
Chapter dues are $20 per year, but new members DO NOT have to pay dues the first year. Chapter dues are waived for Auxiliary Members (Surviving Spouses).
Special Notes:
1. Membership in the Southern Maine Chapter requires that you also be a member of the national organization. National membership dues are $48 per year for Premium Membership. There are also options for Lifetime Membership and Free Basic Membership. Additional information can be found at the following link: http://www.moaa.org/join/
2. Submit Membership Application information via email: Click Here or return this form to:
MOAA Southern Maine Chapter
C/O Membership Chairman
PO Box 27
Harpswell, ME 04079
3. For additional information, please call (207) 837-4335 or contact our Membership Chairman, Rob McAleer at: rmcaleer04079@gmail.com.
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