2014 Senior Staff Application

Senior Staff Application

* Indicates required field

Personal Information

Name *

First

Last

CAPID *

Joined CAP (mm/yy) *

Home Unit *

CAP Grade *

Physical Information

Gender *

T-Shirt Size *

Gym Short Size *

Allergies and Medication

Allergies:
Do you have any food, medication or environmental allergies?

If you answer yes please ensure the "Allergies" section of your Medical Information Form is complete.

Allergies *

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

If you answer yes please ensure the "Allergies" section of your Medical Information Form is complete.

Medications *

Staff Position

Please indicate which staff area you would like to assist with at Encampment.

Area of Interest *

Contact Information

Email *

Primary Phone Number *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Availability

Are you available the entire week of Encampment? *

Do you have a CAP Drivers License? *

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

Please ensure that you hit "submit" when you complete this form
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