Lifetime Membership Migration Link Lifetime member migration planOath Keepers USA Application* First Name * First NameMiddle Name Middle Name* Last Name * Last Name* Email Address * Email Address* Date of Birth * Date of BirthNote: To enter DOB information faster, click on the month and/or year at the top-center of the calendar.* Address * Street Address* City * City* State * State* ZIP * ZIPPhone PhoneAccount Information Account Section* User name * Login ID (No special characters (Ex: !,@,#,$,&,* ...)* Pass word * Pass wordStrength: Very Weak* Confirm Pass word * Confirm Pass wordBackground BackgroundPrevious ServiceI am prior Military, Law Enforcement or First ResponderI am prior Military, Law Enforcement or First ResponderBranch BranchRank RankMOS MOSCurrent Occupation Current Occupation* FeloniesYesNoHave you ever been convicted of a felony?* DischargeYesNoN/AWere you dishonorably discharged from service?* Ham CertifiedYesNoAre you currently Ham Radio Certified?* Medical TrainingYesNoDo you have any level of Medical Training?* CERT CertifiedYesNoAre you CERT (Community Emergency Response Team) certifed?* Political AwarenessYesNoDo you have any training or experience in political activism?Added Information Additional Information* Identification uploadDone(Use Cropper to set image and use mouse scroller for zoom image.)Done(Use Cropper to set image and use mouse scroller for zoom image.)8MB Max - Drop file here or click to select.Please upload copies of your Identification (Drivers License, etc)DD214 Upload8MB Max - Drop file here or click to select.Please upload your separation of service document (DD214) if applicable.Other Information Please provide any other information you might find appliable.Other Information and Comments* E-Signature * Electronic Signature Select Your Payment GatewayAuthorize.netCredit Card NumberCredit Card Number Expiration MonthExpiration MonthExpiration YearExpiration YearCVV CodeCVV CodeHow you want to pay?Auto Debit PaymentManual PaymentPayment SummaryYour currently selected plan : , Plan Amount : Coupon Discount Amount : , Final Payable Amount: Submit
