360 Veterans' Association

Making the Strong, Stronger!

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Please complete this Registration Form apply for membership and gain access to the Members Only portion of 360VA.org

Registration Options

Create Profile

First Name *

Last Name *

Email Address *

Username (lowercase alphanumeric) *

Password (type this twice please) *

password strength indicator

Additional Info

Member Category *

Are you a graduate of a 360° Leaders Course *
Yes No

360° Course Location & Date (MM/YYYY)

Current Military Status *
Active Duty Retired Military Former Military

Current or Last Rank Held *

Service *
Army Navy Air Force Marines Coast Guard (ROTC/Service Academy)

Period of Service Began MM/YYYY *

Period of Service Ended (MM/YYYY or blank if still active.)

Please enter your phone number and mailing address. This information will NOT appear on your 360VA member profile.

Phone Number (###-###-####)

Current Street Address

City

State (Ex. VA)

Zip Code

Home of Record. Again, this information will not appear on your 360VA member profile.

City

State (Ex. VA)

Security Verification

Complete Registration