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2. First Name
3. Last Name
5. Home Phone
6. Cell Phone
8. Branch of Service

   1. Army - USA
   2. Navy - USN

   1. Air Force - USAF
   2. Marines - USMC

   1. Coast Guard - USCG

   *Acronyms for the chosen branch of service will be used to allow for a uniform look and to save space
10. Place of residence at the time of entering the Military
12. Present Address
14. Length of time as a resident of Union
    *Minimum requirement: 20 years as a Township of Union resident
16. Please type on the space below how you would like your request to look.
    Please note each Enrollment Form has a 25 character maximum, this includes space, letters, numbers and symbols.
18. Please attach a copy of the service members DD214 form along with proof of address
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20. 1. Receive an email copy of this form.
21. Email address

    This field is not part of the form submission.

22. Submit

* indicates a required field