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NPMA SkillBridge Program: Service Member Interest

NPMA SkillBridge Internship Program: Service Member Interest Form

Your contact information and data will be kept confidential and used only for the purposes of the SkillBridge Program and reporting requirements to the DoD.

1. Please provide your contact information. *This question is required.

	First Name
	Last Name
	Email Address
	Phone Number

2. I am (select one):

Please enter an 'other' value for this selection.

3. Your branch of service: *This question is required.

Please enter an 'other' value for this selection.

4. Title/Rank *This question is required.

5. Your anticipated separation date: *This question is required. This question requires a valid date format of MM/DD/YYYY.

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6. How many years of service will you have completed when you separate? *This question is required. This question requires a valid number format.

7. If engaging in terminal leave, what date will your terminal leave begin? Please include any time for out processing- we are determining the date when you would be available for full-time employment. This question requires a valid date format of MM/DD/YYYY.

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8. Your current installation location (City, State, Country) *This question is required.

9. US city and state you planning to live and work once you separate from active service.

*NPMA has an extensive network of employers throughout the US- if you train in one area we will assist you with employment in another area. *This question is required.

10. Date you would be available for SkillBridge training: *This question is required. This question requires a valid date format of MM/DD/YYYY.

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11. Please select the best answer that describes where you are in the SkillBridge process. *This question is required.

12. Open Response: Please include any additional details or questions here.

13. Your Commanding Officer's Contact information. *This question is required.

First Name

Last Name

Title/Rank

Street Address

Apt/Suite/Office

City

State

Zip

Email Address

Phone Number