Membership Application

 Download the form If you do not want to register online, you can also print this PDF application and mail it to: Theodore Roosevelt Association, P.O. Box 719, Oyster Bay, NY 11771-0719.


Current Members:

If you do not know your new login ID, you can request assistance by sending an email to membership@theodoreroosevelt.org.

Already Registered? click here to autofill this form
* required information
Registration 
Contact Information
Primary Membership Chapter:*
Secondary Membership Chapter:
Title:*
First Name:*
Middle Initial:
Last Name:*
Email:*
Phone:
Business Phone:
Company Name:
Address Line 1:*
Address Line 2:
City:*
State:*
ZIP/Postal Code:*
Country:
Create Username and Password
Username:*
Password:*
Verify password:*
Security Question:*
Security Answer:*
Fees
Young Assemblyman (under 25)*
$20.00
Military (active duty)*
$50.00
Sworn Police Officer*
$50.00
Sagamore Hill
$70.00
Diplomatic (outside US)
$80.00
Badlands Rancher
$160.00
Rough Rider
$275.00
Conservationist
$550.00
Bull Moose
$1,100.00
Presidential
$2,600.00
Theodore Roosevelt Society (lifetime)
$8,500.00
Donation

If you would like to make an additional tax-deductible donation, please enter an amount below.

Amount:$
Additional Information

CHAPTERS: In addition, all members are invited to become part of a Chapter at no additional cost. Each Chapter offers programming that may include educational and social gatherings, a Public Speaking Competition, a Police Award, and Teddy Bears for Kids. If you wish to be placed in multiple chapters, please contact the National office. Those not wishing to be part of a specific Chapter will be considered At-Large.

* For Young Assemblyman, Military and Police rates, please attach a scan/image of your ID.

Attach Photocopy of ID (for Young Assemblyman, Military and Sworn Officer members only): Click here to attach file

The Theodore Roosevelt Association is a 501(c)(3) corporation founded in 1919 and chartered by Congress in 1920. All membership fees are tax deductible.

BECOME A MEMBER

Join the TRA today and receive the Association's scholarly journal, participate in Association-sponsored travel and tour opportunities and local TRA Chapter activities and events, and receive invitations to all TRA events.

Copyright 2012