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Select Branch: Marines Coast Guard Army Air Force Navy Other

Military Branch (Other):

Type of discharge: Select One Honorable Entry Level Separation General Other than Honorable Clemency Discharge Bad Conduct Discharge Dishonorable Discharge Other... Other discharge:

Rank at discharge: Select One Private Private First Class Lance Corporal Corporal Sergeant Staff Sergeant Gunnery Sergeant Master Sergeant First Sergeant Master Gunnery Sergeant Sergeant Major Sergeant Major of the Marine Corps Second Lieutenant First Lieutenant Captain Major Lieutenant Colonel Colonel Brigadier General Major General Lieutenant General General Warrant Officer Chief Warrant Officer 2 Chief Warrant Officer 3 Chief Warrant Officer 4 Chief Warrant Officer 5 Other... Other rank:

Rank at discharge: Select One Seaman Recruit Seaman Apprentice Fireman Apprentice Airman Apprentice Seaman Fireman Airman Petty Officer Third Class Petty Officer Second Class Petty Officer First Class Chief Petty Officer Senior Chief Petty Officer Master Chief Petty Officer Command Master Chief Petty Officer Gold Badge Master Chief Petty Officer Master Chief Petty Officer of the Coast Guard Ensign Lieutenant (Junior Grade) Lieutenant Lieutenant Commander Commander Captain Rear Admiral (Lower Half) Rear Admiral Vice Admiral Warrant Officer Chief Warrant Officer 2 Chief Warrant Officer 3 Chief Warrant Officer 4 Other... Other discharge:

Rank at discharge: Select One Private Private First Class Specialist Corporal Sergeant Staff Sergeant Sergeant First Class Master Sergeant First Sergeant Sergeant Major Command Sergeant Major Sergeant Major of the Army Second Lieutenant First Lieutenant Captain Major Lieutenant Colonel Colonel Brigadier General Major General Lieutenant General General General of the Army General of the Armies Chief Warrant Officer 1 Chief Warrant Officer 2 Chief Warrant Officer 3 Chief Warrant Officer 4 Chief Warrant Officer 5 Other... Other discharge:

Rank at discharge: Select One Airman Basic Airman Airman First Class Senior Airman Staff Sergeant Technical Sergeant Master Sergeant Senior Master Sergeant Chief Master Sergeant Commander Chief Master Sergeant Chief Master Sergeant of the Air Force Second Lieutenant First Lieutenant Captain Major Lieutenant Colonel Colonel Brigadier General Major General Lieutenant General General General of the Air Force Other... Other discharge:

Rank at discharge: Select One Seaman Recruit Fireman Recruit Airman Recruit Constructionman Recruit Seaman Apprentice Fireman Apprentice Airman Apprentice Constructionman Apprentice Seaman Fireman Airman Constructionman Petty Officer Third Class Petty Officer Second Class Petty Officer First Class Chief Petty Officer Senior Chief Petty Officer Master Chief Petty Officer Command Senior Chief Petty Officer Command Master Chief Petty Officer Fleet/Force Master Chief Petty Officer Master Chief Petty Officer of the Navy Ensign Lieutenant (Junior Grade) Lieutenant Lieutenant Commander Commander Captain Rear Admiral (Lower Half) Rear Admiral Vice Admiral Admiral Fleet Admiral Admiral of the Navy Warrant Officer Chief Warrant Officer 2 Chief Warrant Officer 3 Chief Warrant Officer 4 Chief Warrant Officer 5 Other... Other discharge:

Rank at discharge: