| Prefix | | | First Name * | | | Middle Initial | | | Last Name * | | | Suffix (Ex: Sr, Jr, III) | | | Date of Birth * | | | Address Line 1 * | | | Address Line 2 | | | City * | | | State * | | | Zip Code * | | | E-mail Address: * | | | Phone Number * | | | Dates of Service * | August 2, 1990 - Present
December 20, 1989 - January 31, 1990
August 24, 1982 - July 31, 1984
February 28, 1961 - May 7, 1975
June 25, 1950 - June 31, 1955
December 7, 1941 - December 31 - 1946 | | Branch of Service * | US ARMY
US AIR FORCE
US COAST GUARD
US MARINE CORPS
US NAVY
US MERCHANT MARINES 12/41-12/46 |
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