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Membership in the MOAA Chapter is open to anyone who holds or has ever held a commission or warrant in any component of the Army, Marine Corps, Navy, Air Force, Coast Guard, Space Force, Public Health Service or National Oceanic and Atmospheric Administration and their surviving spouses.
Chapter members are requested to have and maintain a national MOAA membership. Annual Dues are $15.00 ($7.50 for Surviving Spouse/Auxiliary Members). For more information use the Contact Us link on the left.
To join the Charlotte Harbor Chapter of MOAA fill out and submit form on this page and mail a check made out to CHC MOAA to CHCMOAA Membership, P.O. Box 511851, Punta Gorda, FL 33951-1851.
Membership Application
Complete Form and Click Submit Button
Personal Information
:
*
indicates field is required.
First Name:
*
Middle Initial:
Last Name:
*
Suffix:
Type Membership:
Regular New Member
Surviving Spouse New Member
Status:
Select One
Active Duty Officer
Retired Officer
Former Officer
Current Spouse
Surviving Spouse
Date of Birth:
*
(mm/dd/yyyy)
Rank:
Select One
Admiral
Brigadier General
Brigadier General (Army)
Captain
Captain (Army)
Captain (Navy/USCG)
Chief Warrant Office 2 (Navy/USCG)
Chief Warrant Office 3 (Navy/USCG)
Chief Warrant Office 4 (Navy/USCG)
Chief Warrant Office 5 (Navy/USCG)
Colonel
Colonel (Army)
Commander
Ensign
First Lieutenant
First Lieutenant (Army)
General
Lieutenant
Lieutenant Colonel
Lieutenant Colonel (Army)
Lieutenant Colonel (USAF/USMC)
Lieutenant Commander
Lieutenant General
Lieutenant General (Army)
Lieutenant Junior Grade
Major
Major (Army)
Major General
Major General (Army)
Miss
Mr
Mrs
Ms
Rear Admiral
Second Lieutenant
Second Lieutenant (Army)
Vice Admiral
Warrant Officer 1 (Army/USMC)
Warrant Officer 2 (Army/USMC)
Warrant Officer 3 (Army/USMC)
Warrant Officer 4 (Army/USMC)
Warrant Officer 5 (Army/USMC)
Service:
Select One
ANG
ARNG
NOAA
USA
USAF
USAFR
USAR
USCG
USMC
USMCR
USN
USNR
USPH
None of the Above
Spouse's Name:
Mailing Address:
*
City:
*
, FL
Zip Code:
*
Phone:
*
Email:
*
Please include me in broadcast emails to the chapter.
National Membership Status:
Visit www.moaa.org for information
I wish to join National MOAA. Please contact me with information.
I AM A CURRENT NATIONAL MOAA MEMBER.
Member#:
Please indicate all Chapter Activities in which you have an interest in participating:
Select one or more of the below activities & click
>>>
to add to the list on the right.
These are my choices.
To delete from the list select and click
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to remove
Membership
Surviving Spouse
Auditor
Comments/Questions:
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