Last Name

First Name

MI

Sex

M

F

Service Branch

Pay Grade

Status

MOS/AFSC

Job Title (do not abbreviate)

Years of Service

Home Unit

Home Post/Base or City if no base

State/Country

Your Email Address

1st Relative FIRST and LAST Name(s)

Relationship to You

Street Address

City

State

Zip Code

2nd Relative FIRST and LAST Name(s)

Relationship to You

Street Address

City

State

Zip Code

3rd Relative FIRST and LAST Name(s)

Relationship to You

Street Address

City

State

Zip Code

4th Relative FIRST and LAST Name(s)

Relationship to You

Street Address

City

State

Zip Code

Spouse name must be filled when selecting an INLAW

in the above blocks. Spouse's Name (First and Last Name)

The blocks here are optional (not required) for National Guard and Reserve members

Current Residence City

State

Civilian Employer or Co. Name

Your Civilian Job Title or Position

Received a:

Diploma

G.E.D.

N/A

Name of High School or GED Institution

Grad Year

City

State

Zip Code

1st College Degree

Grad Year

1st College Name (fill only if awarded degree)

City

State

2nd College Degree

Grad Year

2nd College Name (fill only if awarded degree)

City

State

Event Date

Phone#

PAO E-mail Address

Comments. Use only if necessary to help process the news release form (150 character limit. No punctuation or special characters allowed)

If attaching a file to this form, check this box:

PAO Code

KILL

BATCH

STORY

UniqueID:

JOINT HOMETOWN NEWS SERVICE NEWS RELEASE INFORMATION

STEP 1: MEMBER INFORMATION

STEP 2: RELATIVE INFORMATION

YOUR LIVING PARENTS, INLAWS, STEPPARENTS, GUARDIANS, GRANDPARENTS OR ADULT CHILDREN

STEP 3: EDUCATION INFORMATION

(FOR ANY BLOCK THAT DOES NOT APPLY, LEAVE IT BLANK)

For college information, fill ONLY IF AWARDED A DEGREE

STEP 4: RELEASE INFORMATION

Event (100 char limit): Promotion to(rank), arrival for duty(where), award(type), deployment in support of, redeployment, etc...

Hometown News Use Only

STEP 5: PHOTOS AND OTHER ATTACHMENTS, and SUBMIT FORM

Note: If you open attachment window, click FINISH to return to form.

then,

By choosing to submit this form electronically, I certify and agree that I have read and understand the Privacy Act and release consent information and that I bind and legally obligate myself to the same extent as I would by signing my name on a printed paper version of this form (DD2266).

DD2266 MAY2010 V2