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Membership Application

To Join, go to http://NSUMAC.CLUBEXPRESS or Print This Form and Mail Along with Check to MILITARY ALUMNI CHAPTER P.O. BOX 16272 Arlington, VA 22215-1272.
FIRST NAME: LAST NAME: MI:
SSN: Birthdate (Mo/Day): Spouse:
Address1: Address2:
City: State: ZIP: Email:
Home Telephone: Work Telephone:
Rank: Status: Service Source: Service:
Year Attended NSU (from - to):
04 & Above:
1 Year at $100.00
2 years at $150.00
3 years at $225.00 		03 & Below:
1 Year at $60.00
2 years at $100.00
3 years at $150.00 		Civilian:
(Non-military retiree)
1 Year at $60.00
2 years at $100.00
3 years at $150.00 		Life Member 04 & Above:
1 Year at $75.00
2 years at $100.00
3 years at $150.00 		Life 03 & Below:
1 Year at $35.00
2 years at $50.00
3 years at $75.00 		Life Civilian (non-military)
1 Year at $35.00
2 years at $50.00
3 years at $75.00 		ROTC Cadet:
1 Year at $15.00
2 years at $25.00
FOR MEMBERSHIP YEAR(s) 1 July _____ thru 30 June _____ ////// Recruited/Reclaimed by:______________________
Type of Membership?
Renewal New
To Join, go to http://NSUMAC.CLUBEXPRESS or Print This Form and Mail Along with Check to MILITARY ALUMNI CHAPTER P.O. BOX 16272 Arlington, VA 22215-1272.