OAANY Membership Form

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First Name *

Last Name *

Mailing Address *

City *

State *

Zipcode *

Cell/Telephone *

Email Address *

Membership Type *

$40 for families (including dependent children)

$25 for individuals (ages 18+)

$15 for college students (student ID required)

Membership Year *

2026 - 2027 (August to August)

Additional Elections (Optional)

I would like to an additional donation to OAANY

I would like to contribute to the OAANY scholarship fund

I will make payment by: *

Check made out to OAANY* (Mail to: OAANY c/o Mariko Middleton, 10 Nelson St. #2, Montpelier VT 05602)

Who referred you to the association/How did you find out about OAANY?

Please add me to the Volunteer Team for future OAANY events

Yes please.

No thank you.

Please select which information you would like published in our membership directory. Please select all that apply. *

Name

Phone

Please do not publish my information in the directory

Required

Do you have Okinawan ancestry? *

Yes

If you are Okinawan, where are your ancestral roots? If not sure, please indicate 'not sure'.

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