HEART OF TEXAS CHAPTER



HEART OF TEXAS CHAPTER

MILITARY OFFICER ASSOCIATION OF AMERICA

P.O. BOX 23964 WACO, TX 76702-3964

WEB SITE:

2021 HEART OF TEXAS CHAPTER

MEMBERSHIP APPLICATION AND RENEWAL FORM

Annual HOT Chapter dues of $25 come due for current members as of 1 Jan.

Dues for new members will be pro-rated depending on when they join the chapter.

Chapter dues are separate cost from membership in National MOAA.

Dues are required from spouses if the spouse desires to have chapter voting privileges or would like to hold an officer or director position in the chapter.

Date:

Name:

Nickname:

Branch of Service: Rank:

Spouse’s Name:

Address:

Regular Auxiliary:

Phone: Home: Office: Cell:

E-Mail:

Military Member Service Dates (AD, Reserve, NG)*:

Birthday (Month & Day) Member: Spouse:

Anniversary:

Member Spouse

Would you like to receive newsletter by E-Mail? Yes No

Do you have cable broad band Internet capability? Yes No

Are you or your spouse interested in playing golf? Yes No Yes No

Are you a member of National MOAA? Yes No Yes No

If yes, basic, annual or life time? (Circle One)

If a MOAA member, list MOAA number:______________________

*The Chapter’s tax-exempt status is partially dependent upon percentage of regular members who are war veterans as defined by the IRS. Therefore, we are requesting the regular member’s service dates to insure that we are in compliance.

For additional information, please contact Vince Tobola, 254-709-5795, vtobola@ .

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