fill out the following information. The only required
fields are marked by a red asterisk (*). The only
information we display is the state and symptoms.
No personal information is displayed. --Please
do not put your last name in the username section
when you register!--
following form registers you with us as a victim of
the water contamination at Camp LeJeune. The Username
and Password that you register will give you access
to the discussion group with the ability to post messages
and reply to messages left by other victims.
reserve the right to review all pertinent information
in regards to exposure and to accommodate only those
victims who meet appropriate criteria.