Navy Nuclear Weapons Association

Online Application Form

Renewing members may send a check with Renewal in the memo line or pay online. No form required unless information has changed.

After you fill out the online application and click on the submitt button, you need to go back to the main page click on “Membership”, then click on the patch to pay with PAYPAL.

Items marked with ** are required for reinstating or new members or form will not submit.

By submitting this form you are certifying that all information is true and correct to the best of your knowledge.

If you do not apply online:

Make checks payable to: NNWA Treasurer

Mail to: Don Schultz 573 Beaulieu Loop The Villages, FL 32162

**Name

**Address

E-Mail Address

**Phone

Emergency Contact

**Option **Option Enroll as new member. $15.00 annual dues, $10.00 application fee ($25.00 total) Enroll as associate member. $15.00 annual dues, $15.00 application fee ($30.00 total) Enroll as heritage member. $15.00 annual dues, $10.00 application fee ($25.00) total Reinstatement of past member. $15.00 annual dues, $10.00 application fee ($25.00 total) Renew. $15.00 annual dues. May renew for as many years as you like.

**List commands and dates where you served for qualification:

**Date of entry into NW/GMT/WT "A" School:

**Rank/Rate on separation:

** Separation ** Separation Discharged Retired

You may publish my: You may publish my: Address Phone E-mail

**Electronic notification: **Electronic notification: Yes No

2 + 10 =

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