MEMBERSHIP APPLICATION
First Name:	Middle Initial:	Last Name:
Nickname:	Class Year:	Primary E-Mail Address:
Phone Number:	Rank:	Service:	Status: Active Retired Reserve Civilian
Spouse's Name:
Please check any and all that apply    This is a membership renewal.    I am a surviving spouse of the listed member.    I do NOT want to be listed in the directory.    This is a new membership information request.

NAMETAG ( New applications or replacements only)
Please Select YES NO   I would like a name badge with my donation of $35 or more.
If yes, please type your name below EXACTLY as you would like it to appear on the badge.
HOME ADDRESS
Street (Line 1):	Street (Line 2):	Apartment/Suite/Unit:
City:	State:           Zip Code:	Home Phone:
WORK ADDRESS
Street (Line 1):	Street (Line 2):	Apartment/Suite/Unit:
City:	State:           Zip Code:	Work Phone:
Check here if you would like to have someone call you.

  Members are requested to make an annual minimum donation of $30 in lieu of paying GWC dues.  This money is
  used to help defray the costs of the Chapter's Academy Awareness Program, targeting area young men and
  women and providing them information and encouragement to apply for admission to USNA.  Your generosity is
  appreciated.

                                                             U.S. Naval Academy Alumni Association
                                                                        Greater Washington Chapter
                                                                 2550 Huntington Avenue, Suite 202
                                                                             Alexandria, VA 22303

                                  Checks should be made payable to: USNAAA-Greater Washington.