Membership Application

For New or Renewal Memberships

(Current Members: Enter name and changes only)

Name:

Sex: 

 

Age: 

  

Member Status: 

Address:

City:

State: 

Zip:  

Phone:

    E-mail: 

 

If married, spouse’s first name:

Last name, if different than yours:

Regular Member: 

Active duty, retired, or former military officers are eligible for Regular membership.

Service:    Rank:

Present Military Status:

Dues:     $20 per year;       5 years for $90       Active Duty and those 90 and older: free!

Note:  Free Members please put 00 in the Dues box and 00 in the Total Amount box (unless making a donation).

Auxiliary Member: Widows or Widowers whose spouses were members or were eligible for membership.  

Rank of spouse:        Service of spouse:

Dues:        $15 per year;        5 years for $60;         Those 90 and older: free!

Dues : $        Donation: Scholarship & Community Services $  

Total Amount I am Submitting: $  

 There are 2 ways to pay. Check or Credit Card.  Indicate your payment Method: 

By Check:  Provide any comments and press the Submit button below.  Maill your check to: Hawaii Aloha Chapter MOAA, PO Box 201441, Honolulu, HI 96820, with a memo note on the check saying what it is for.  

With a Credit Card:  Remember the total amount you are paying.   Provide any comments and press the Submit button below.  You will be taken to a page where you will make your payment.

Questions?  Call Lawrence Enomoto at (808) 255-8971 or email: lawrence.enomoto@gmail.com

  
Comments or Information Request: