Name:
Email:
Phone:
Dept:
Select Department
AL OPS
AOPE
BIO
EDU
FAC
G&G
LIB
MAR
MAR OPS
MC&G
MPC
PO
I cannot participate in the program at this time.
I may be available to participate in the
following month/year:
Month
January
February
March
April
May
June
July
August
September
October
November
December
Year
2004
2005
2006
2007
2008
2009
2010
Please contact me then.
I wish to participate in the program.
Is there anything you'd like us to know as we
consider a partner for you?
Hobbies:
Aviation
Cooking
Gardening
History
Photography
Politics
Reading
Theatre/opera
Traveling
Woodworking
Other:
Sporting Activites:
Biking
Fishing
Golf
Hiking
Running
Sailing/boating
Scuba diving
Skiing
Swimming
Tennis
Other:
Favorite Travel Destinations:
Africa
Alaska
Asia
Caribbean
Europe
Hawaii
India
South America
Tropics
US East Coast
US West Coast
Other:
Interests:
Other comments or suggestions?