DLI ALUMNI ASSOCIATION (DLIAA) - REGISTRATION FORM
                                    PERSONAL INFORMATION (Student, Faculty, and Staff)
                                                            Fields marked (*) are required
     Last Name:  (*)  
 Last 4 of SSN: (optional but desired)
   First Name:    (*)
EMail Address: (*)
Middle Initial:  (if any) (*)  
EMail (Again):   (*)
                  (USA, USN, USAF, USMC, Civ, or AM)
Mil Service:     (*)   AM = Associate Member

Phone Number (in case we need to contact you)
                           (Monterey,  SF, Lackland, Wash)
Training Location: (*) 
STUDENT INFORMATION

                                   Language  Studied                  Grad (Mo & Year)                         Comments (if any) about your DLI experience
1st Time at DLI:  (*) (*)    
2nd Time at DLI:                                          
3rd Time at DLI:        

                                                    Languages you taught                              Worked at DLI  (From and To Dates)
FACULTY INFORMATION:                                                         Highest Position Held                                 Worked at DLI  (From  and To Dates)
     STAFF INFORMATION:        

   Hometown (City andState):    Web Page (if any):
          Do you want the above information to be released to other members?:  If  NOT, change to NO
                                                                           STOP!!! 
  BEFORE SUBMITTING FORM, PLEASE GO BACK AND REVISE ALL YOUR ENTRIES