This is a NEW APPLICATION for membership in RAFINO, please complete ALL items applicable on the form, send it electronically.

If you make a mistake while filling out the form, just click on CLEAR FORM at the bottom of this form and begin again. After completing the form, be sure to click on SUBMIT FORM. Changes for existing members can be reported on a form in the Roster pages.

1. Name
Last Name (required):
First Name (required):
Middle Name/Initial (required):
Jr/Sr:
Nickname:
Pay Grade (if this is a new application):

2. Spouse
(First Name):

3. Address
Street (including Apt/Suite) / PO Box:
City:
State:
Zip (including Plus 4):

4. Telephones
Home Phone (include area code):
Unpublished (Y/N):	Yes No
Business Phone (include area code):
Fax (include area code):

5. E-mail (Primary):

6. Date of Birth (Mo / Day / Yr):

7. Present Occupation:

8. Other Branch / Service (if retired as Non-Finance Corps/Army)

9. Are you still on Active Duty?	Yes No
Date Retired (Mo / Day / Yr):

10. Alternate Address (Location where you may temporarily reside on a regular basis each year. Example: Florida residents who escape the heat to Michigan)
Address
Street (including Apt/Suite ) / PO Box:
City:
State:
Zip (including Plus 4):
Telephone
Months at this alternate site (normally)	From: To: Inclusive