American Veteran Search Enrollment Form

Your Contact Information *REQUIRED

*First Name:
Middle:
*Last / Maiden Name:
Nickname:
*Home Phone:
Work Phone:
Fax Number:

Address:
City:
State:
Zip:
Country:
Birth date: (ex: 05/20/42)
*Email Address:

Branch of Service:

Army Navy Air Force Marines Coast Guard

Joined Service:
(ex: 01/01/80)

Left Service:
(ex: 01/01/80)

Platoon:

Battalion:

Division:

Company:

Command:

Place Stationed / Ship Name:

Rank:

Boot Camp:

Where:

When: (ex:1957)

Brief Description of Service:

Are you an active member of any veterans group?
Yes No If Yes, Which? (abbreviate, If Necessary)

Gladly Accepted!
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ATTENTION : After your credit card information has been accepted you will see on the top on the last page "YOU MUST CLICK HERE TO SELECT YOUR USER NAME AND PASSWORD", If you don't click on these words YOU WILL NOT BE ABLE TO SEARCH THE DATABASE.