Registration Form
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FIRST NAME
LAST NAME
EMAIL
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MOBILE PHONE
CITY
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AREA(S) OF INTEREST
Benefits
Education
Employment
Family Support
Housing
Recreation
Volunteer
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Newsletter
MILITARY SERVICE HISTORY
Military Branch:
Army
USMC
Navy
USAF
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Status During Enlistment:
Reserves
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RANK
GRADE
SERVICE DATES (ENTRY DATE TO DISCHARGE DATE)
Current Status:
Active Duty
Reserves
In-Active
Discharged
Retired
HEALTHCARE
Are you enrolled in VA Healthcare?
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No
Unsure
Are you enrolled in Civilian Healthcare?
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No
Unsure
Are you enrolled in eBenefits?
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No
Unsure
EDUCATION
DEGREE(S) EARNED
SCHOOL(S)
Which of the following education benefits are you currently using?
None
Ch 1606
Ch 1607
Ch 30
Ch 33
Ch 35
Are you enrolled?
Yes
No
Have you graduated?
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No
If yes, when?
CURRENT LIVING CONDITIONS
Own
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Transitional
Other
Are you seeking housing?
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No
SERVICE CONNECTED
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Do you need help filing a claim?
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VETERAN ORGANIZATIONS YOU ARE AFFILIATED WITH
Marital Status
Wounded Warrior Project
American Legion
VFW
Other
Other
CURRENT EMPLOYMENT STATUS
Employed
Unemployed
Unemployed and Seeking
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Full-Time Student
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EMPLOYER
POSITION
DESIRED EMPLOYMENT
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Administrative and Business Services
Agriculture and Natural Resources
Arts, Media, and Entertainment
Building Trades and Construction
Education, Child Development, and Family Services
Energy and Utilities
Engineering and Design
Fashion and Interior Design
Finance and Insurance
Health Science and Medical Technology
Hospitality, Tourism, and Recreation
Information Technology
Manufacturing and Product Development
Marketing, Sales, and Service
Public and Government Services
Self-Employed
Transportation and Logistics
DESIRED INDUSTRY
DESIRED EMPLOYER
DESIRED POSITION
Resume Upload
Please Upload Resume
FAMILY
Marital Status
Married
Single
Divorced
Widowed
Do you have children under the age of 18?
Yes
No
If so, how many?
By filling this form, you give us permission to contact you about veterans events and/or benefits.
Battleship IOWA Museum
250 S. Harbor Blvd, Los Angeles, CA 90731
866.535.7624 * reboot@nvtsi.org
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