application

Name:

Address:

City, State, Zip:

,

Phone:

Area Code: - Phone:

Email Address:

Choose a Program:

Choose One Bahama Bay Resort Victorian Resort Washington Nationals Baseball San Diego Padres Baseball Washington Redskins Football San Diego Chargers Football

Dates that you would like to use the condo/resort/Baseball tickets: ex: March 6-10, 2006 (Resort stays are limited to 7 days)

Please Check Availability

• Bahama Bay I
• Bahama Bay II
• Bahama Bay III
• Bahama Bay IV
• Victorian
• Baseball Program
• Football Program

Service:

Choose One Army Marine Corps Navy Air Force

Component:

Choose One Active Reserve National Guard Retired

Pay Grade:

Choose One E1 E2 E3 E4 E5 E6 E7 E8 E9 O1 02 03 04 05 06 WO CWO2 CWO3 CWO4

Marital Status: (Check one)

yes: no:

Number of Dependents:

Ages of Dependents: (Separate with commas)

Will you require help with transportation?

yes: no:

Are you medically discharged for wounds or injuries sustained in combat operations?

yes: no:

Do you or a member of your family use a wheel chair?

yes: no:

Have you been awarded the Purple Heart?

yes: no:

One of the following documents must accompany this application as evidence of your eligibility:

DD 214, DD 215, WD AGO 53-55, General Orders or DD 1300

Applications without the required documentation of eligibility will NOT be processed.

You may attach the required forms as a .pdf or .jpg file

File Attachment:

File Attachment: