Membership PhoneThis field is for validation purposes and should be left unchanged.Name(Required) First Middle Initial Last Select Organization(Required)NCOA Rogue ChapterNCOA Roguette AuxiliaryStatus(Required) Active Duty Retired National Guard Reserve Veteran Family Member Other DOB(Required) MM slash DD slash YYYY BranchPay GradeRankAddress(Required) Street Address City State / Province / Region ZIP / Postal Code Home Phone(Required)Cell Phone(Required)Email(Required) Chapter Number (or Name)Sponsor Name (If known)Regular/Associate or Veteran Annual Membership Price: Regular/Assoc. or Veteran Membership Options 1 Year 2 Year 3 Year 6 Year Life Through Age 50 Life 51-60 Life 61+ Auxillary Annual Membership Price: Auxiliary Membership Options 1 Year 2 Year 3 Year 6 Year Life Through Age 50 Life 51-60 Life 61+ NCOA Scholarship Fund Donation NCOA Scholarship Fund – Scholarships are awarded to children / spouses of NCOA members. NCOA Bettsy Ross Fund Donation NCOA Bettsy Ross Educational Fund – Provides grants to members of the International Auxiliary wanting to take classes/courses to improve their employable skills.NCOA Disaster Relief Fund Donation NCOA Disaster Relief Fund – Provides relief for immediate disaster-related needs to military members and their families who suffer losses as a result of natural disasters such as hurricanes, fires, floods, earthquakes, etc.NCOA Membership Development Donation Vanguard Life Member $100 (Must be Life Member) Coupon (Payable to NCOA) Total Δ
