Connect to a Marine For Life Representative

Complete this form to connect with the Marine For Life Network representative near you.

First Name:*

Last Name: *

Email Address: *

Phone Number:

DoD ID Number/EDIPI if applicable (found on military ID card):

Military Status: *

What state are you located, or relocating to? *

If known, what city are you looking for resources and connections in? *

Please provide a detailed description of how we can assist you:*

How did you hear about the Marine For Life Network?*

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Wounded Warrior: If you are seeking assistance with services related to a wound Illness or Injury during your service, contact the Sergeant Merlin German Wounded Warrior Call Center at 877-487-6299.

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