tftptf Lejeune Illness Registry

Camp Lejeune Illness Registry and advocacy are our purpose.

Please pass the mouse pointer over the underlined question marks if you need more information on an option.

Username: * ?

Current Password:

First Name: * ?

Middle Name/Initial: ?

Last Name: * ?

Current City/Town: * ?

Current State/Province: * ?

Email: * ?

You can only enter numbers, commas, spaces, dashes, opening parentheses and closing parentheses into the next field. Please enter your primary telephone number.

Primary Phone: ?Please provide your primary telephone number in a standard national or international format.
This information will NOT be displayed to other users.

You can only enter numbers, commas, spaces, and dashes into the next field. Please enter only the year(s) you were on board Lejeune.

What years were you at Camp Lejeune: * ?Please provide the years that you were aboard Camp Lejeune full or part time. Years only, please. Enter the 4 digit year(s). Like This: 1970 - 1980 OR 1971, 1975, 1978.
This information will be displayed to other users.
Notes about your years at Camp Lejeune: ?Please provide any notes concerning the circumstances that found you aboard Camp Lejeune here.
This information will NOT be displayed to other users.
Address on Camp Lejeune: ?Please enter the address(es) where you lived while at Camp Lejeune, if any.
This information will NOT be displayed to other users.
Organization: ?Please enter the organization that you were with on Camp Lejeune. If you were not there as part of an organization (a spouse, a dependent,etc.) then please just leave this blank.
This information will NOT be displayed to other users.
MOS: ?Your Military Occupation Specialty while aboard Camp Lejeune or, if a civilian, your career field? If you were not there as part of a career or job (a spouse, a dependent,etc.) then please just leave this blank.
This information will NOT be displayed to other users.

As with most list boxes, you can type the letters of a word into the box and it will get you close to the selection
that you want.

Select all that apply by either:
1.) pressing the Ctrl key and clicking on options with the mouse, followed by using the buttons

OR

2.) by double clicking with the mouse ** some browsers will not support this.

The buttons are pretty self-explanatory.

There may be a delay between when you press the button and when the information appears in the other selection box
because of the need to sort the information as it moves between boxes.

Please be patient.

Possible Conditions: ?Select all that apply by either pressing the Ctrl key and clicking on options with the mouse then using the button - by double clicking with the mouse if you use IE.

My Conditions: * ?My Conditions - you can remove any selections that you place here by mistake.

Other: ?Please enter other information here: additional conditions, more details, anything else that you want the registry to know about your exposures at Lejeune.
This information will be displayed to other users.
How did you find tftptf * ?Please tell us how you found out about tftptf.com.
If Other: ?Please tell us what other information source brought you to tftptf.com