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Do you have prior Military service?

First Name:

Last Name: Street Address:

Street Address 2: (optional)

Zip Code: City: State: Date of Birth: Home Phone:
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Mobile Phone: - - (optional) Email Address:
Yes! I would like to learn more about receiving a higher education.
Please send me information.

Please tell us a little about yourself.

What is the highest level of school you have completed? High School:

What is your high school graduation date?(optional)   What is Your Gender?
What is your U.S. citizenship status? 
What is your ethnic background? 
Career of Interest:
Pick A School: Choose a degree program:


Collection of information is authorized by Title 5 U.S.C. 301, Departmental Regulations, and E.O. 9397. For official use only when filled in. is not and does not represent DOD in any way. is a private company that provides job/career information at no cost to interested prospects.

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