Focus Marines Foundation


FOCUS Application - Part I
Please fill out all the information requested below. After the FMF Executive Director reviews Part I of your application, we will call you to discuss the next steps in the application process.
1.0 Personal Information
* = Required
Please enter your name exactly as it will appear on your ID at the airport.
First Name *
Middle Name
Last Name *
Preferred Name
Gender *
Street *
Apartment
City *
State *
Zip *
Date Of Birth (mm/dd/yyyy) *
Primary Phone # *
Secondary Phone #
When is the best time to reach you?
Email *
Marital Status *
Number of Children *
2.0 Military History:
Service Branch(es) *	USMC USN USA USAF USCG
DD-214 *
Enlisted Date (mm/yyyy) *
Discharge Date (mm/yyyy) *
Discharge Type *
Pay Grade *
MOS *
OIF/OEF *
Do you have a Combat Casualty Nurse (or "none") *
Please list other veteran-support programs you've attended (or "none") *
How did you hear about FMF FOCUS? Please include name, if possible. *
Why do you want to attend FOCUS? *

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