Opt In Form ~ Lawton DFAS Alumni.Org

Opt-In submission form to have your name and city/state listed on the members Alumni/Alumnae page.

E-mail Address: *
Title *
First & Last Name *	example: John Doe
How would you like your location to appear? *	example: Indianapolis, IN
Please let us know a little more about you. The following information WILL NOT appear on the page but we need the information so we can pass along requests to you. The address, city, state & zip requested is your address, not the center or field site you worked at.
Street Address #1 *	example: 123 Main Street
Street Address #2 if needed	example: Appt 1025 or Route 9
City *
State *
Zip Code *
Add to mail list? *
Birthday - any format & year not needed
Comments

Verification Code:
Enter Verification Code: *


* Required