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Nformation may preclude processing of DMNA Form 96-1 - Complete application and return by 15 August for the Fall semester, by 15 December for the Spring semester, and TO BE DETERMINED for Summer Courses. * ALSO SEE PAGE 3 OF THIS APPLICATION 1. SERVICE MEMBER DATA b. NAME (Last, First, Middle Initial) a. Date of Birth: c. RANK e. ETS/EOS (YYMMDD) d. SSN f. MAILING ADDRESS & E- Mail Address: (Street, City, State, Zip Code & full e-mail address) g. UNIT OF ASSIGNMENT & ADDRESS i. Status (ci.

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