East Carolina University. Tomorrow starts here.®
 
Division of Continuing Studies
Military Outreach


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Military Outreach
 
Personal Information
 
First

MI
Last
Local Street Address
City
State
Zip

Home Phone
Work Phone
Cell Phone
Email
 
 
Enrollment Status
Are you currently enrolled in college?  
If yes, where?
Last institution attended was:
Other degrees held?
From where?
 
Program of Interest
What program are you interested in?
Expected entrance: Year: Term:
Entrance status:
Attendance status:
 
Military Information
Active Duty
Reserve
Spouse
Dependent
Government Contractor
If you are a dependent, please list the name of the military person and relationship to you.
Full name:
Relationship:
Dates of Military Service:
Rank:
Permanent Duty Station:
Military Occupation(s):