2014 Basic Cadet & NCOA Application

Basic & NCOA Application

* Indicates required field

Personal Information

Name *

First

Last

CAPID *

Joined CAP (mm/yy) *

Home Unit *

CAP Grade *

Program Choice *

I am willing to participate in a Cadet "O" Flight *

Yes No

Physical Information

Date of Birth (mm/dd/yyyy) *

Height (inches) *

Weight (pounds) *

T-Shirt Size (adult sizes) *

Eye Color *

Hair Color *

Gender *

Gym Shorts Size (adult sizes) *

Contact Information

Email *

Primary Phone Number *

Mailing Address *

Line 1

Line 2

City

State

Zip Code

Country

Allergies and Medications

Allergies:
Do you have any allergies to foods, medications, or environmental factors?

If you answer yes please ensure the "Allergies" section of your CAPF 160 is complete.

Allergies *

Medications:
Do you take any prescription, over the counter or supplemental medications?

If you answer yes please ensure the "Medication" section of your CAPF 160 is complete.

Medications *

Please ensure that you hit "submit" when you complete this form
It may take up to 5 minutes for the file to finish uploading...please be patient.

Submit

Basic & NCOA Application

Personal Information

Physical Information

Contact Information

Allergies and Medications

Allergies:Do you have any allergies to foods, medications, or environmental factors?

Medications:Do you take any prescription, over the counter or supplemental medications?

Please ensure that you hit "submit" when you complete this formIt may take up to 5 minutes for the file to finish uploading...please be patient.

Please mail your completed forms to: Maj. S Riis, 1015 Highland Drive, Epsom NH 03234

Allergies:
Do you have any allergies to foods, medications, or environmental factors?

Medications:
Do you take any prescription, over the counter or supplemental medications?

Please ensure that you hit "submit" when you complete this form
It may take up to 5 minutes for the file to finish uploading...please be patient.