Membership Application

Date:


Name: 


Home Address:


City/State/Zip:  


Telephone:


Duty Station or Employer:


PRD:


Business Address:


City/State/Zip:  


Telephone:


Position/Billet:


Status: 
Active Duty 
Naval Reserve 
Retired 
Civilian




Rank/Rate:  
 

Desig.: 


Email Address:


Please use my (choose one): 

Home Address 

Business Address



Sponsor:

Chapter Affiliation:
Annapolis
Arabian Gulf
Bath, Maine
Charleston
Coastal Bend
Dahlgren
Great Lakes
Greater New York
Greater Washington
Hampton Roads
Korea
Mayport/Jacksonville
MidSouth (Memphis, TN)
Monterey
Naples/Gaeta
New Orleans
Newport
Pascagoula
Pearl Harbor
Philadelphia
Puget Sound
San Diego
Sasebo
Tampa Bay
USS CONSTITUTION
Yokosuka
Non Affiliated
Other 

Membership Fees:

Active Duty Annual:			
O-7 & Senior: $30.00			
O-6: $25.00		
O-4/O-5: $20.00		
CWO/O-1, O-2, O-3: $15.00			
Midshipmen: $10.00		
E-7/E-9: $15.00		
E-6 and below: $10.00		
Retired/Civilians Annual: $25.00		


Active Duty Three Year:

O-7 & Senior: $75.00
O-6: $62.50		
O-4/O-5: $50.00		
CWO/O-1, O-2, O-3: $37.50			
Midshipmen: $25.00		
E-7/E-9: $37.50		
E-6 and below: $25.00		
Retired/Civilians Annual Three Years: $62.50		
			


Life Membership Dues (Payment plans are available)
Active Duty and Drilling Reseve to age 50: $350.00
Active Duty and Drilling Reserve after age 50: $250.00
Retired/Civilian:		
	
Under Age 40: $450.00
Age 41-50: $350.00
Age 51-60: $250.00
Over Age 61: $150.00





Gift Membership from: 


Sponsor from: 


Payment: (Choose one)

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