November 12 & 13
Fort Campbell USO | 9-4 Daily
Workshop Registration Form
Name
*
First
Last
Personal Email
*
example@example.com
Are you registering as the spouse of a servicemember?
*
Yes
No
Servicemember's Name
*
First
Last
No Military Emails! Personal please!
The firewalls don't allow our .org domain...we have a hard enough time reaching folks
Phone Number
*
Please enter a valid phone number.
What is your unit?
*
5th SFG (A)
160th SOAR (A)
Other
What is your MOS?
*
Approximate Separation/Retirement Date:
*
/
Month
/
Day
Year
Date
What is your paygrade?
*
Select One
E-01 through E-5
E-6
E-7
E-8
E-9
WO1
CW2
CW3
CW4
CW5
O-1
O-2
O-3
O-4
O-5
O-6
What is your current time in service?
*
Select One
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30+
What type of separation will you have?
*
Select One
ETS/REFRAD/UQR/Other
Standard Retirement (20+ years)
Medical Retirement
Do you have a LinkedIn Profile?
*
Yes
No
What questions / concerns do you want addressed at this workshop?
There are a limited number of spaces available. By submitting this form, you are acknowledging that you will make every effort to attend the entire day's session, and provide maximum advanced notice in the event that you can no longer attend. Thank you!
Submit
Can't register without personal/non-official email
Go back up and fix it, then come back.
Should be Empty: