Tri-Wing Encampment 2012

Basic Cadet Application

Please note: All fields are mandatory.

First Name

Last Name

CAPID

CAP Grade

Unit Charter Number
(ex. MER-MD-079)

Street Address

City

State

Zip Code

Email Address

Phone Number
(ex. 4105551234)

Date of Birth
(ex. mm/dd/yyyy)

Gender

How will you be departing the encampment?

Further Departure Information

If a relative or friend will be picking you up from the encampment, please provide their contact information. If you've selected other, please explain.

Emergency Contact Numbers

Home
Father Cell
Mother Cell
Father Work
Mother Work

If you do not have any of the above phone numbers, please enter "N/A".