NMSOA Application Form

Please make checks or money orders for
Annual Dues = $20.00 or for 3 years Dues = $50.00

Lifetime Memberships
30 to 40 years $350.00
40 to 50 years $325.00
50 to 60 years $275.00
60 to 70 years $225.00
70 to 80 years $150.00
80 and older $50.00
All Lifetime payments must be payed in full and by check or Money Order, NO partial payments will be accepted. Please memo check "Lifetime Membership" and include your birthdate. Any applicant whose 31st, 41st, 51st, 61st, 71st or 81st birthday will occur after the date of application and on or before December 31st of the current calendar year, shall pay only the fee that would be required on their next birthday.

payable to: 

NMSOA


Please mail c/o :

Gabby Dibaczy

Box 562

Bordentown, NJ  08505


Last Name___________________________ First Name_____________________________ Middle Initial______
Spouse's Name__________________________________
Street Address_______________________________________________________________
City_______________________________________ State_________________ Zip Code__________________
Country_________________________________________ Phone Number______________________________
Date of Birth__________________________________ Type of Discharge_______________________________
Email Address______________________________________@______________________________________

Amateur Radio Call Sign__________________ ARRL Member As member of the NMSOA this give you the privilege of being part of
the Navy MSO Amateur Radio Club, this club is for all MSO Crews.

New Member     Renewal Membership Number________________

I have read and agree to the Constitution and ByLaws of the NMSOA.

MSO / MSO's served on and years aboard, including Rate/Rank. (example: USS Conflict MSO-426 1968-1970 RM2)
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________

Are you a member of any MSO Association (Please list with expiration date)
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________

Comments / Questions:
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________