Military Officers Association
of America

You don't have to be retired to join MOAACC's ranks!

MOAACC is the third largest MOAA Chapter in the United States. Membership is open to active duty, retired, former officers, Reserve, National Guard, and Warrant Officers of the seven uniformed services: Army, Navy, Air Force, Marine Corps, Coast Guard, Public Health Service and National Oceanic and Atmospheric Administration. Auxiliary (Spouses) memberships also are available.

The annual membership is only $20. Life membership is $155 for those 80-89, $235 for those 70-79, $330 for those 60-69, $400 for those 50-59 and $460 for those 40-49. The annual membership is due with your application. The life membership can be paid over 3 consecutive months.

Select one New Chapter Member Annual
Life Member
Change of Address  

First Name	MI
Last Name
Spouse's Name
Street Address
City
State	Select State FL - Florida AA AE AK - Alaska AL - Alabama AP AR - Arkansas AS- American Samoa AZ - Arizona CA - California CO - Colorado CT - Connecticut DE - Delaware DC - District of Columbia FM - Federate States of Micronesia GA - Georgia GU - Guam HI - Hawaii IA - Iowa ID - Idaho IL - Illinois IN - Indiana KS - Kansas KY - Kentucky LA - Louisiana MA - Massachusetts MD - Maryland ME - Maine MH - Marshall Islands MI - Michigan MN - Minnesota MO - Missouri MT - Montana MP - Northern Mariana Islands MS - Mississippi NC - North Carolina ND - North Dakota NE - Nebraska NH - New Hampshire NJ - New Jersey NM - New Mexico NV - Nevada NY - New York OH - Ohio OK - Oklahoma OR - Oregon PA - Pennsylvania PR - Puerto Rico PW - Palau RI - Rhode Island SC - South Carolina SD - South Dakota TN - Tennessee TX - Texas UT - Utah VA - Virginia VI - Virgin Islands VT - Vermont WA - Washington WI - Wisconsin WV - West Virginia WY - Wyoming
Zip Code	-
Country
SSN	- -
Date of Birth	- - (ex. day/month/year 11-08-1935)
Telephone
FAX
E-mail Address
MOAA Nat'l #
MOAA/TROA Member since
Service	Select Service USA (Army) USMC (Marine Corps) USN (Navy) USAF (Air Force) USCG (Coast Guard) USPHS (Public Health Service) NOAA (Nat'l. Oceanic and Atmospheric Admin.)
Rank/Title*	Select Rank 1LT 1stLt 2LT 2ndLt ADM ASG AST BG BGen BrigGen CAPT CDR Col CPT CW2 CW3 CW4 CW5 CWO2 CWO3 CWO4 CWO5 DIR DSG ENS FULL Gen LCDR LT LTC LtCol LTG LtGen LTJG Maj MajGen MG Miss Mr. Mrs. Ms. RADM SAST SGEN SR VADM WO1
Select one*	Active	Retired	Former Officer	Auxiliary
Select one	Active Duty	Reserve	National Guard
Select one
	Male	Female

Permission to list my name? (please check each)
The MOAACC Chapter Directory
MOAACC Web Page

Why are you joining MOAACC? (please check all that apply)
A friend is a member
To participate in the chapter programs
To retain my military affiliation
To support MOAA's legislative efforts
To receive The Intercom
Thursday Morning Breakfast Club
Monthly Luncheon Speakers

Would you be willing to assist in the operation of MOAACC? If so, what would be your main area of interest?
Legislative Affairs
Public Relations
Membership
Scholarship & Award
Personal Affairs
Legal Counsel
Newsletter
Chaplain
Finance
Programs (Speakers)
Meeting Setup
Activities
Data Processing

Please make check payable to: MOAACC
Check #

Mail to:
MOAACC Secretary
PO Box 254186
Patrick AFB, FL 32925-4186

WELCOME ABOARD!!!

Please make contact with our Membership Chairman
COL Jack Bobst at 321.757.0678