Survey - Our Lives, Our Rights Personal Stories

Are you an active-duty service member or veteran? Share your story with us.

(All submissions are confidential unless you give us permission to share and publish it. If permission is given, then your story may be featured on our website and / or featured in our campaign emails.)

1.

Please provide the following information

*

Name:

First Required	Last Required

*

Email: Required

City/State/ZIP:

City	State	ZIP

Country:

Phone Number:

Gender:

If you respond and have not already registered, you will receive periodic updates and communications from PEP.

Remember me. What's this?

2.

Question - Not Required - Please use the following space to Sound Off

*3.

Question - Required - Do we have your permission to share or publish this submission?

Enlistment and deployment information

*4.

Question - Required - Branch of Military Service (check all that apply)

	United States Army (USA)
	United States Marine Corps (USMC)
	United States Navy (USN)
	United States Air Force (USAF)
	United States Coast Guard (USCG)
	Army National Guard of the United States (ARNG)
	Army Reserve (USAR)
	Marine Corps Reserve (USMCR)
	Naval Reserve (USNR)
	Air National Guard of the United States (ANG)
	Coast Guard Reserves (USCGR)
	United States Military Academy (USMA)
	United States Naval Academy (USNA)
	United States Air Force Academy (USAFA)
	United States Coast Guard Academy (USCGA)
	United States Merchant Marine Academy (USMMA)

5.

Question - Not Required - Date entered service

Month

Day

Year

6.

Question - Not Required - MOS

(Maximum response 255 chars, approx. 5 rows of text)

7.

Question - Not Required - Secondary enlistment date (if applicable)

8.

Question - Not Required - ETS Date

Month

Day

Year

9.

Question - Not Required - Secondary ETS Date (if applicable)

10.

Question - Not Required - Deployments (Country - Year)

(Maximum response 255 chars, approx. 5 rows of text)