2008 MEMBERSHIP RENEWAL SHORT FORM

                Virginia Peninsula Chapter of the Military Officers Association of America - VIPMOAA

1.  NAME:  ____________________________________________________     

2.  CHANGES (NOTE ADDRESS LABEL ON NEWSLETTER):

                ADDRESS:  ________________________________________  ____________________ _____ _________

                PHONE NUMBER WITH AREA CODE:  _____________________________  RANK: _______

                SPOUSE’S NAME:  __________________________________________   EMAIL:  ________________________________

                OFFICER’S MILITARY STATUS (changes only):  ACTIVE. RETIRED. VETERAN. RESERVE, GUARD __________

3.  THIS IS HOW I WANT TO BE INVOLVED IN VIPMOAA IN 2008:  __________________________________

  _________________________________________________________________________________________________________________________

Please use separate checks if paying for meeting and membership renewal.  It helps with accounting.

4.  2008 DUES (check payable to VIPMOAA)

            [  ] REGULAR MEMBER (Officer) $15

            [  ] AUXILIARY MEMBER (Widow or Widower of Officer) $10

MAIL TO: VIPMOAA – PO BOX 4305 FORT EUSTIS, VA  23604-4305

               

5. SIGNATURE:____________________________  DATE:  _________