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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
Male
Female
Left Blank
Mailing Address
Apt #
City
State
Postal/Zip Code
Housing
Post
Off-Post
Home Phone (xxx)xxx-xxxx
Cell Phone (xxx)xxx-xxxx
Work Phone (xxx)xxx-xxxx
Work Extension
Sponsor Email Address (AKO Preferred)
Re-type to Confirm Email Address
Military/Civilian Status
--Choose One--
Active Duty Mil (AR/AF/NA/MC)
Active Duty Coast Guard
Full Time National Guard
Full Time Reservist
Eligible DOD Contractor
CYS - Direct Care
DOD Civ (APF/NAF/AAFES/DODDS)
Non-DOD Federal Employee (GSA/NSA/etc)
Sponsor=Private Sector/Not Oth Auth
Sponsor=Retired Military
Spouse=Student
Spouse=Unemployed
Sponsor=Gold Star Spouse
Combat Related Wounded Warrior
If Military, Branch
N/A
If Military, Grade/Rank
N/A
Spouse Information
Check Here if No Spouse
Name of Spouse (First)
Name of Secondary Guardian (Last)
Gender
Male
Female
Left Blank
Cell Phone (xxx)xxx-xxxx
Work Phone (xxx)xxx-xxxx
Work Extension
Spouse Email Address
Military/Civilian Status
--Choose One--
Active Duty Mil (AR/AF/NA/MC)
Active Duty Coast Guard
Full Time National Guard
Full Time Reservist
Eligible DOD Contractor
CYS - Direct Care
DOD Civ (APF/NAF/AAFES/DODDS)
Non-DOD Federal Employee (GSA/NSA/etc)
Spouse=Employed Other Than DOD/Fed Gvt
Sponsor=Retired Military
Spouse=Student
Spouse=Unemployed
Sponsor=Gold Star Spouse
Combat Related Wounded Warrior
If Military, Branch
N/A
If Military, Grade/Rank
N/A
Emergency Contact Information
What are Emergency Contacts?
Two people (other than parents)
we can contact and/or release your
child to in case of an emergency.
Name of Emergency Contact (First)
Name of Emergency Contact (Last)
Contact Home Phone w/ area code
Contact Work Phone w/ area code
Contact Cell Phone w/ area code
Relationship
#1
#2
* REQUIRED DATA
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