------FORM STARTS ------US ARMED FORCES CAC ID CARD – DATA FORM ------
Fill one form for each id card you purchase – read the instructions before!
-IF YOU WANT TO LEAVE BLANK A FIELD ANSWER WITH: ‘N/A’
- IF YOU WANTTO LEAVE US TOINSERT SOME DATA (FOR EXAMPLE ‘CARD NUMBER’ OR ‘SERVICE NUMBER’) THEN ANSWER WITH THREE SLASHES: ‘///’
PAY ATTENTION WHEN WRITE YOUR DATA: ON THE ID CARD THEY WILL APPEAR EXACTLY AS YOU WROTE THEM IN THIS FORM: ABBREVIATIONS, CAPITAL LETTERS/WORDS AND DATES.
FORMAT OF DATES AND OTHER DATA
-BECAUSE OF THE SMALL SPACE, DATES CANNOT BE WRITTEN IN THEIR FULL FORMAT (E.G.: 9 JANUARY 1967 CANNOT BE WRITTEN). ALL DATES WILL BE WRITTEN IN ONE OF THE FOLLOWING FORMAT:
· 0000MON00– E.G.:9 JANUARY 1967-> 1967JAN09
- ID CARD WILL BE CUSTOMIZED WITH COMPUTER
PLEASE FILL ALL SPACES
CUSTOMER NAME :
write the same name shown on your paypal home address
TYPE OF ID CARD
mark ONE of the following options
SELECT BRANCH OF SERVICE
- US ARMY [ ]
- US MARINE CORPS [ ]
- US NAVY [ ]
- US AIR FORCE [ ]
- US COAST GUARD [ ]
- DOD CONTRACTOR 1 [ ]
- DOD CONTRACTOR 2 [ ]
- DOD FOREIGN NATIONAL [ ]
- MILITARY AFFILIATE [ ]
- US ARMY CONTRACTOR [ ]
- US MARINE CORPS CONTRACTOR [ ]
- US NAVY CONTRACTOR [ ]
- US AIR FORCE CONTRACTOR [ ]
- US COAST GUARD CONTRACTOR [ ]
- US ARMY CIVILIAN [ ]
- US MARINE CORPS CIVILIAN [ ]
- US NAVY CIVILIAN [ ]
- US AIR FORCE CIVILIAN [ ]
- US COAST GUARD CIVILIAN [ ]
- DOD CIVILIAN [ ]
- DOD CIVILIAN RETIREE [ ]
PHOTO SECTION
NOTE: PHOTO WILL BE PRINTED IN “COLORS” ON FRONT SIDE AND IN “BLACK & WHITE” ON BACKSIDE
PHOTO REQUIRED (ANSWER WITH ‘YES’ OR ‘NO’):
IF ANSWER IS ‘YES’ please send the photo together with this form (or insert it in the white space on last page of this form), to the email address shown in the contact us section on www.joysingersids.com (.JPG OR .BMP FORMAT, NO LOW RESOLUTION IMAGES)
GENERAL DATA SECTION
BRANCH (only for military affiliate ID card):
LAST NAME:
FIRST NAME:
MIDDLE NAME or MIDDLE NAME INITIAL:
PAY GRADE (OR GRADE):
RANK:
ISSUE DATE:
EXPIRATION DATE:
BLOOD TYPE:
DONOR (answer “yes” or “no”):
DATE OF BRITH:
SOCIAL SECURITY NUMBER:
GENEVA CONVENTION CATEGORY:
Some data may not be used because not necessary. Just to be sure, please fill all sections.
ONLY FOR UNIFORMED SERVICES ID CARDS
(ARMY, MARINE CORPS, NAVY, AIR FORCE, COAST GUARD)
not available for contractors or DOD ID cards
SELECT STATUS (mark only ONE of the following)
- ACTIVE DUTY [ ]
- RESERVE [ ]
- NONE [ ]
if “Active Duty” or “Reserve” are selected, a green Active Duty or Reserve writing will be put under the seal. Otherwise, if “None” is selected, nothing will appear under the seal.
REMARKS
-ONCE YOU WILL GIVE US YOUR DATA AND THEY WILL BE PRINTED ON THE ID CARD THEY CANNOT BE REMOVED OR MODIFIED IN ANY WAY. SO PLEASE CHECK DOUBLE TIME THE INFORMATION YOU GIVE IN THIS FORM.
INFORMATION PROVIDED IN THIS FORM WILL REMAIN STRICTLY CONFIDENTIAL
------FORM ENDS------US ARMED FORCES CAC ID CARD – DATA FORM ------
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