Join Us!

Thank you for your interest in joining the Northwestern Michigan Chapter of MOAA.

Please fill out the following form and our Membership Chair will follow up with you via email.

Thank you for your continued service and joining our community!

Name

First Name

Last Name

Rank

Branch of Service

Status

Active

Retired

Former

Reserve

National Guard

Surviving Spouse

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Date of Birth

YYYY

Phone

(###)

###

####

Are you a Member of MOAA?

Yes

Unknown

MOAA Member Number (if known)