Sign Up for a Care Package

Today's Date*
Date Format: MM slash DD slash YYYY
Service Member Last Name*
Service Member First Name*
Gender*
Different items are sent in care packages depending on gender.
Mailing Address Line 1*
Assigned Military Address. For example: Unit Name or Ship Name.
Mailing Address Line 2
Assigned Military Address. For Example: Unit 000000 Box 0000.
Designation*
USPS Designation Assigned by Military, For Example: APO, FPO, DPO, FSC.
State*
USPS State Assigned by Military, For Example: AP, AE, AA.
Zip Code*
Minimum 5 Digits, Zip Plus 4, if Available.
Expected Return Date*
Date Format: MM slash DD slash YYYY
Requester Name
First Last
Requester's Email Address*
Enter Email Confirm Email
CAPTCHA
Date
Date Format: MM slash DD slash YYYY