Type or neatly print your full name. If you already have a road name, put where indicated. If you want to pick your own Road Name, go ahead, this isn't an MC. Recommend something short that pertains to you personally, ("SLUGGO", etc.), rather than something that make you appear to have over-compensation issues ("DRAKE BLAZEMASTER", etc.)
Regarding you email address, use upper and lower case, don't just put all capitals unless it actually IS in all capitals.
Your "Combat Unit" is whichever one you were in theater with at the time, which may not have been your unit at the time of separation (EAS). Be as specific as possible, so someone up the chain of command doesn't have to look anything up... "1/25" could mean a dozen different units, for example, but "1st Bn, 14th Inf Reg't, 25th ID" is extremely clear.
Your "Combat Area" is the theater of operations that was listed as a combat zone by the DoD at the time you were there.
Re: the CADL, Proof of current registration, and proof of current insurance, boxes, a chapter officer checks those off once he's seen them, not you.
For all new applicants, your application packet can either be submitted up the Chain of Command by the Chapter Secretary (Stag) or by the Chapter Commander (Sea Panda). Once you've been approved, then you are authorized to purchase your Back Patch. You'll also need to pay your National dues of $20, and your Chapter Dues of $20 (that's annual, NOT monthly!)
Please submit all completed form to the Chapter Secretary, Stag (trooper1127@yahoo.com) or the Chapter Commander, Sea Panda (diveroo@yahoo.com) for processing.