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*Member ID:
Prefix:
1LT
2LT
CAPT
CDR
CMDR
COL
Col (Ret)
CPT
Dr.
ENS
LCDR
LCMDR
LT
Lt Col (Ret)
LTC
LTCOL
LTG
LTJG
MAJ
Mr.
Mrs.
Ms.
Prof.
Rev.
*First Name:
Middle Name:
*Last Name:
Suffix:
I
II
III
IV
Jr.
Ph.D.
Sr.
V
VI
Class Year:
N/A
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
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1991
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1989
1988
1987
1986
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1984
1983
1982
1981
1980
1979
1978
1977
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1975
1974
1973
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1971
1970
1969
1968
1967
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1965
1964
1963
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1961
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1949
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1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
1919
1918
1917
1916
1915
*Address:
*City:
*State:
Zip Code:
Country:
*Phone Number:
Email Address:
Outfit:
Associate Member/No Outfit
A Battery
A Company
Artillery Band
B Battery
B Company
C Battery
C Company
Infantry Band
Maroon Band
White Band
Associate member?
Incorrect address?
Deceased?
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Last Name:
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Member ID: