Please complete the following information about your household

* REQUIRED DATA
User Name (up to 50 chars)
Password (up to 50 chars)
Re-Type to Confirm
Sponsor Information
Who is the Sponsor?
- If dual military, sponsor = highest ranking
- If military + civilian, sponsor = military
- If dual civilian, sponsor = your choice
Name of Sponsor (First)
Name of Primary Guardian (Last)
Gender
Sponsor Email Address
Re-type to Confirm Email Address
Alternate Email Address
Mailing Address
Apt #
City
State
Postal/Zip Code
Home Phone xxxxxxxxxxxxxxx
Cell Phone xxxxxxxxxxxxxxx
Work Phone xxxxxxxxxxxxxxx
Work Extension
Country
Housing
Spouse Information
Check Here if No Spouse
Name of Spouse (First)
Name of Secondary Guardian (Last)
Gender
Military/Civilian Status
Emergency Phone w/ area code
Emergency Contact Information

	Name of Emergency Contact (First)	Name of Emergency Contact (Last)	Contact Cell Phone w/ area code	Contact Home Phone w/ area code	Contact Work Phone w/ area code	Relationship
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