Apply Using Printable Form

Thanks to the talents and efforts of Lt Col Cydridge “Zeke” Gray, you may now fill out and email your application from the comfort of your laptop.  Please fill the form attached below and either

1- digitally sign then email to Tammy Graves at or

2- print the filled out form, manually sign and scan to Tammy Graves at or mail to Tammy at PO Box 627, Jackson, MS 39205.

Please ensure to include your email address and phone number.

We will send you a confirmation email upon receipt by our office.  Please be aware that it may take a couple of days to process the form and send the email.

Instructions for completing the form are also attached.  You will need Adobe Reader and will not be able to send from a .mil account due to the encryption requirements.  Please contact either Tammy Graves at 601-354-7555 or or Maj Gen (Ret.) Cris Crisler at 601-594-3571 or


AFBA Printable Form

Instructions for filling out Life Insurance Application