Full Name

Email

Street Address

City

State

Zip Code

I want to update my contact information. (update below)

Veteran

TRUE

Not a Veteran

TRUE

Thanks for being an IAVA member! Please review your information and make any necessary changes.

I want to update my veteran status.

Welcome to IAVA!

Please tell us more about yourself.

Are you a Veteran

YesNo

Service Information

Branch:

Status:

Type of Service:

Deployed to (Select all that apply):

IraqAfghanistanOther DeploymentOther EraDid not deploy

Number of Deployments:

Year of Most Recent Deployment:

Submit your paperwork (DD214 preferred)

Additional Information

Veteran Family Member

Yes

Survivor of Veteran

Yes

Contact Information

First Name

Last Name

Email

Street Address

City

State (two letter abbreviation)

Zip Code (5 digits)