Please mail application to: Spokane Chapter P.O. Box 466 Veradale WA 99307
Please Print or Type
NAME ___________________________________________ RANK ______________________
ADDRESS ________________________________________ ZIP_________________
PHONE___________________ E-MAIL ______________________________
MOAA NAT’L NO. ____________________ NAME OF SPOUSE ____________________________
SERVICE ___________________________ STATUS (Circle One): Active Retired Former Officer Auxiliary
Date of retirement or separation (if applicable) ____________ CIVILIAN OCCUPATION _____________________
How did you find our web site?
National MOAA ____ LOCAL CHAPTER MEMBER ___________________________ OTHER _______________________
I enclose $ ___________ for Chapter dues. To join the Spokane Chapter of MOAA, membership is required in MOAA National. Current national members do not qualify for a free trial membership.
Please check one that applies.
____ I am a member of MOAA National.
____ I have never been a member of MOAA National.
If never, I accept the one-year free trial membership in National MOAA. Open to active duty, retired, National Guard, Reserve, former commissioned officers and warrant officers of the following uniformed services: Army, Marine Corps, Navy, Air Force, Coast Guard, Public Health Service and National Oceanic and Atmospheric Administration.
Signature ______________________________________ Date ______________