How To Join Our Chapter Please complete this form and send. Dues are $25 per year. Once we receive your application, we’ll provide additional information. Welcome to our chapter! Please enable JavaScript in your browser to complete this form.Name *FirstLastAddress: Number and Street OR PO Box number *Number and Street OR PO Box numberAddress: City *City NameAddress: State *State NameAddress: Zip *Zip CodeRank and Status *Rank (for example: 1st Lt, Major, Commander, Captain, Colonel, etc.); Status (Active, Retired or Former Officer)Service Component *Air ForceArmyCoast GuardMarinesNavyNOAAPublic Health ServiceOtherPlease check oneChapter Recruiter (Sponsor)Add name of sponsor, if applicableTelephone Number(s) *Home Phone, Cell, or BothAre You a National MOAA Member? *YesNoNo, but I plan to applyPlease pick oneBirth Date *Use Day, Month, Year (for example: 29 Sep 54)Spouse's Name (if applicable)Email *GDPR Agreement *I consent to having this website store my submitted information so they can respond to my inquiry.Email *Custom Captcha * = Submit – OR – Contact Len Yelinek here for membership questions, or call (702) 362-7673.