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Are you (or your spouse) separating/have you separated from active duty military service in southern California (San Diego, Riverside, Imperial or Orange counties)?
Please select...
Yes
No
From what location/installation are you separating/did you separate from active duty service?
Where do you plan to reside after separation?
Please select...
Southern California (SD, Orange, Riverside, Imperial, San Bernadino Counties)
I am not sure
Other
Other: Plan to reside
First Name:
Last Name:
Email address (please do not use your military email)
(non-military Email)
Phone number:
Current Address: Street
Please do not use a PO Box or APO/FLO
City
State
Zip
Identified gender?
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Male
Female
Other
Prefer not to state
Ethnicity
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American Indian or Alaska Native
Asian
Black or African American
Native Hawaiian or Other Pacific Islander
Hispanic or Latino/a
White
Two or More
Prefer not to disclose
Where did you hear about zero8hundred?
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TAP Anchors
TAP Bowling Alley
TAP Coronado
TAP Point Loma
Miramar TRS Class
Camp Pendelton TRS/Mini career fair
MCRD TRS/Career Panel
Coast Guard TAP class
Military Family Collaborative Spouse Class
MCRD STARS Class
Miramar STARS Class
Camp Pendelton STARS Class
Friend
Spouse
Command
Social Media (please specify)
Base Advertising (please specify)
Website
Other (please specify)
Social Media, Base Advertising or Other: please specify
Please choose the role that best describes you.
Please select...
Active Duty
Veteran
Reservist
National Guard
Active Duty Spouse
Reservist Spouse
Veteran Spouse
National Guard Spouse
With which branch of service are you currently associated?
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Navy
Marine Corps
Air Force
Army
Coast Guard
National Guard
Reserves
US Public Health Service/NOAA
Other: please specify
Are you separating or retiring?
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Separating
Retiring
What is your rank?
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E1
E2
E3
E4
E5
E6
E7
E8
E9
WO1
WO2
WO3
WO4
WO5
O1
O2
O3
O4
O5
O6
O7
O8
O9
Are you prior enlisted?
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Yes
No
What is your current or anticipated discharge status?
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Honorable
Other Than Honorable
General Under Honorable
Bad Conduct
Dishonorable
Prefer not to state
What is the month and year of your separation/retirement date from active duty? (MM/YYYY format only please)
(MM/YYYY)
What is your date of birth?
(DD/MM/YYYY)
What is your marital status?
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Not Married
Married
Divorced
Separated
Widowed
Prefer not to disclose
How many children do you have under the age of 18?
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0
1
2
3
4
5
What is your highest education level?
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Not yet high school
High School Diploma
Some College
Associates Degree
Bachelors Degree
Graduate Degree
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Agree
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Terms of Use
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