Online Membership Form

Please fill out the membership form below and submit it. Fields with * are required. If you receive an error after submission, please check that all fields with * are filled in or contact oakleafdc@gmail.com.

Application Information


Your First Name*

Your Last Name*

Your Email*

Your Phone Number* (XXX) XXX-XXXX

Join or renew?*

Your Military Information


Are you yourself a member of the military?* (Your spouse military information can be entered later.)


Your Military Status

Your Military Branch

Your Pay Grade

Spouse/Partner Information


Please provide the following information about your spouse or partner.

Spouse First Name*

Spouse Last Name*

Spouse Military Status*

Spouse Military Branch*

Spouse Pay Grade

Spouse Duty Station*

(If 'Other', please specify)

Spouse Department*
Examples: "GME", "OB/GYN", "Navy Marine Corps Public Health Center", etc.

Spouse Job Title/Area of Responsibility*
Examples: "Student (please indicate year)", "Intern", "Resident", "Attending", "Base Command"

Additional Information


Home Address*

Home Address Line 2

City*

State*

Zip*

Interests

Other interests

Complete the application


One Last Thing…
Please let us know who connected you to Oakleaf or how you heard about us (name of member, website, Facebook, etc)

If you are new to Oakleaf and to the area, we will follow up with a phone call or email so we can connect you with groups you are interested in.

When you click Submit, you will be automatically redirected to our payment page. Our membership chair will reach out through email to confirm your membership.