Please print-out
this form, complete, and return with your remittance to the address at the
bottom of the form. Please call/email us, if you have any questions
regarding this application. Thank You !!
__________________________________________________________________________________________
(Rank/Full Name)
(DOB: Day/Mo/Yr)
_______________________________________________________________________________________________________________________
(Mailing Address, with Apartment or Lot Number)
________________________________________________________________________________________________________________________
(City, State, ZIP)
Home Phone:
(_____)_____________________________________
Business Phone: (_____)___________________________________
Email:__________________________________________________
FAX:
(_____)___________________________________________
Military
Service Branch (circle one): USA, USN, USMC, USAF, USCG, USPHS, NOAA
Military Status (circle one): Active Duty, Retired, Former, Reserve,
National Guard
Dates
of Service _________________________________________
(From
Year - To Year)
Hereditary Membership eligibility is based on relationship with:________________________________
Spouse’s First Name:_____________________________________
___$350 Regular Perpetual * ___$87.50
Installment
____ $40 Regular Annual
___$350 Hereditary Perpetual* (21 and Older) ___$87.50
Installment
____ $40 Hereditary Annual
___$200 Hereditary Perpetual* (20 and Younger) ___$50.00
Installment
____ $40 Former Member
___$200 Perpetual (any age, 1st year Commissioning as 2nd LT, Ensign, or
WO (any grade) )
___$200 Memorial Perpetual (Must be paid in full) Annual Chapter Dues $ _____
$15.00 of the national dues is applied to a subscription to
Officer Review magazine.
*
Perpetual memberships are a one-time cost and may be paid in four quarterly
installments as listed above
Applicant’s Signature
__________________________________________________________
Date
_____________________________
Sponsor’s Rank/Name (if applicable)
______________________________________________
Sponsoring
Chapter (if applicable)
________________________________________________
Mailing Address: The
Military Order of the World Wars, 435 N. Lee Street Alexandria, VA 22314
Toll Free 1-877-320-3774, FAX (703) 683-4501, Email: moww@comcast.net
Rev. January 1, 2007