Your Name (required)

Your Email (required)

Address (required)

Address Line 2

City (required)

Zip Code (required)

State (required)

Phone (required)

Date of Birth (mm/dd/yyyy) (required)

Gender (required)

Branch (required)
Air ForceAir Force ReserveArmyArmy ReserveCoast GuardMarine CorpsMarine Corps ReserveNational GuardNavyNavy Reserve

Service Status (required)
DischargedRetiredTDRLPDRLPending Med BoardActive/Returning to Active

Rank (required)
E1E2E3E4E5E6E7E8E9O1O2O3O4O5O6O7O8O9O10W1W2W3W4W5

Type of Discharge (required)
Type of DischargeHonorableGeneral Under Honorable ConditionsAdministrativeGeneral Other Than Honorable ConditionsBad Conduct Discharge

Start of Service (mm/dd/yyyy) (required)

End of Service (mm/dd/yyyy) (required)

How did you learn about IATW? (required) FacebookWord of MouthNew ChannelWeb siteIATW EventGoogle SearchOther Social Media

Preferred Method of Communication (required) EmailPhone CallText MessagePostage

Eligibility of Service

As part of the verification process, we ask that you please submit a copy of your (or, if a caregiver/family member, your warrior’s) DD 214

If you are unable to attach the information at this time, you will receive an email after submitting your registration form with additional options for submission.

Upload Eligibility Document (required)

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