Request for Information about Veteran and Military Services

Please tell us a little about yourself.

* denotes a required field

First Name (Given) *

Last Name (Surname / Family Name) *

Alternate Last Name (i.e. Maiden Name)

Birthdate (requested for data consistency purposes) *

Email Address *

Phone

Highest degree earned *

Where? Search for your school: *

Military Status

What is your U.S. military status?

Are you currently serving in the U.S. military?

Yes

No

Have you previously served in the U.S. military?

Yes

No

Are you a spouse or dependent of a veteran or service member?

Yes

No

Please select which military branch

Please select your anticipated entry term *

Would you like to request an appointment with our office?

Yes

No

Great! A Le Moyne representative will follow up with you shortly.

Please list any area(s) of interest that you would like to learn more about.

Area(s) of interest