Enlistment Application

Last Name__________________ First Name________________ M.I.________ 

Date of Birth________________ Photo I.D. #___________________

(Please enclose copy of photo I.D. with enlistment application)

Address___________________________________________________________

Phone________________________ E-Mail______________________________

Prior/Current Military Experience _____YES ______NO

If Yes, Explain:

___________________________________________________________________

Mail Application and copy of photo I.D. to:

Jeff Cornell  

RR #1 Box 293B  Neoga, IL 62447

 

 


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