RAUS Lifetime Membership Application

RAUS
RETIRED ASSOCIATION FOR THE UNIFORMED SERVICES, INC.

RAUS Membership Application

Step 1: Complete the form below and click on the button to go to Step 2.

*Denotes required field
Member Number (For Office Use Only)
Member First Name *
Member Middle Initial *
Member Last Name *
Spouse's First Name
Spouse's Middle Initial
Spouse's Last Name
Address *
City *
State *
ZIP Code *
Home Phone *
Email Address *
Member Social Security Number *	(999-999-9999)
Member Date of Birth *	(mm/dd/ccyy)
Spouse Social Security Number	(999-999-9999)
Spouse Date of Birth	(mm/dd/ccyy)
Branch *
Rank *
Service Number *
Military Entry Date *	(mm/dd/ccyy)
Discharge Date	(mm/dd/ccyy)
Check One: *	Retired Widow(er) TRR Active Duty
Military Retirement Date:	(mm/dd/ccyy)

5-Year Membership	$60.00
3-Year Membership	$37.00
1-Year Membership	$15.00

Life Membership (Based on age range)

	40 or less	41 to 45	46 to 50	51 to 55	56 to 60	61 to 65	66 to 70	70 and up
Age Range Life Dues:	$325	$300	$275	$250	$225	$200	$175	$100

Please select a membership option:

Regular Membership Election
By typing my name in the box below, I hereby request membership in RAUS to take advantage of the member-only association benefits. I am including the initial membership dues and understand that continued membership and benefit enjoyment requires renewal of my membership upon expiration of the initial period.

Life Membership Election
By typing my name in the box below, I hereby request a Life membership in RAUS to take advantage of the member-only association benefits. As a Life Member, I/we will be exempt from future dues increases. My Life Membership will be effective for the life of both myself and my spouse. In addition to my RAUS membership card, my Life Membership Certificate provides a document in hand as a record of my membership for my future needs. I acknowledge that my Life Membership dues payment is not refundable.

Authorization: Type Your Name Here:

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