Southwest Florida Chapter
Become a Member
MILITARY OFFICERS ASSOCIATION
P.O. Box 1212
Naples, FL 34106-1213
MEMBERSHIP APPLICATION (Initial/Renewal)
Name: Last: ________________________________First___________________________________Middle_____________________________
Rank: _______ Branch of Service: _____________ Duration of Service: From ____________ To _______________
NOTE; Verification of Service is highly recommended.
Status: Active: _____ Retired: ______ Former _____ Other _____ Surviving Spouse: _______
Date of Birth: ______________(mm/dd/yy) Spouses' Name: _______________________
Southern Address: ______________________________________________________________________________________________________
Northern Address: ______________________________________________________________________________________________________
Reside in Florida: ________ months per year
Telephone #: ________________ Cell #: _________________ Alternate: _______________________
E-mail address: _________________________________ MOAA Member # (if applicable): ____________
Chapter Participation Interest (circle): Annual Military Ball JROTC Fundraising Judicial/Legal matters Presenters/Speakers Public Relations
Personal Affairs Other: ________________________________
Officers 90 years of age and older do not pay annual dues. To facilitate your introduction to the membership, a brief resume of your military service is requested but not required. Attach a copy of proof of warrant or commissioned service.
Your $30.00 Annual Dues may be paid by check (preferably) or online for $32.00.
New Members: Submit your application and verification to , pay online or mail to: MOASWF Membership, P.O. Box 1212, Naples, FL 34106
Renewals: Annual Dues is due by January 15th of each year. Pay online ($32.00) or by mail ($30.00). Mail to: MOASWF Membership, P.O. Box 1212, Naples, FL 34106 Annual Dues renewal will be sent out in November.
Signature: ________________________________________ Date: _________________________