October 1 | 9-4
Waikiki Elks Lodge 616
Registration
Spouses are welcome and encouraged to attend!
Name
*
First
Last
Personal Email
*
example@example.com
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.
Format: (000) 000-0000.
Branch of Service
*
Please Select
Army
Navy
Marines
Air Force
Coast Guard
Space Force
Unit Assigned
*
SOCPAC
INDOPACOM
Other
What is your MOS?
*
Approximate Separation/Retirement Date:
*
/
Month
/
Day
Year
Date
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
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
Do you have a LinkedIn Profile?
*
Yes
No
Spouses are encouraged to attend this event. Will your spouse attend?
*
Yes
No
Spouse's Name
*
First Name
Last Name
Spouse's Email
example@example.com
Source
Can't register without personal/non-official email
Go back up and fix it, then come back.
Submit
Should be Empty: