THE RETIRED ENLISTED ASSOCIATION

ONLINE MEMBERSHIP APPLICATION
Please Note:  If you are mailing your application with your
check or faxing your application, DO NOT click "Submit Form", simply
print out the page after you have filled it out.

Name:  Birthdate:
Address:
City: State: Zip:
Telephone No: (xxx-xxx-xxxx): Fax No: (xxx-xxx-xxxx):
Email Address:
Branch of Service:    Grade/Rank:
Chapter: Recruiter: Member No.

I understand that, with acceptance of my application, I will be covered by $1000 Accidental Death Insurance and such other benefits as may become effective during my membership. 

New Application
Renewal, Enter Your
Membership No.
Name: 
QPL Payment, Enter Your
Membership No.
Name: 
 
Payment Options: Send credit card information or check information through our secure server.
Credit Card No:
Name as it Appears on Credit Card: 
Expiration Date:
Checks Online (Remember to click Submit Form below to submit the application, before going to Checks Online)
If you prefer not to send this information through our secure server, this form may be printed out and mailed to:
TREA HQ-Membership
1111 S. Abilene Ct.
Aurora, CO 80012
Enclosed is my check
DO NOT CLICK SUBMIT FORM if you are mailing with your check.  Print out the screen, and mail.
Applications received online without payment information will not be processed.

You can also print this form out and fax it. Either enter your credit card information, or fax a copy of your check
(we can process your check electronically)
Fax:  (303/752-0835 or 888/882-0835).