Senior Member Registration

Name *

First

Last

Phone Number *

Email *

Address *

Line 1

Line 2

City

State

Zip Code

Country

What are you interested in volunteering for? (select all that apply) *

What is your availability? *

I plan to be there the whole week (July 17-25) I plan to be there for more than half of the week I plan to be there a couple of days

CAPID *

Home Unit *

NON NH UNIT/ COMMANDER CONTACT EMAIL *

Grade *

Do you have a CAP drivers license? *

Yes No

Do you have any of the following certifications? *

First Aid CPR Lifeguard None of the Above

Gender *

Male Female

T Shirt Size *

Short Size *

Have you already received your Covid-19 vaccine? (Vaccine is required for those 16+) *

Yes No - I plan to get it prior to July 1st No - Please contact me to discuss

Additional comments about availability or volunteer opportunities? *

I understand that all participants (students and staff) ages 16 and up are required to receive a Covid-19 vaccine prior to attending the 2021 NH Summer Academy program. *

Yes, I Understand

By submitting my application, I understand that this does not guarantee me a confirmed slot at this year's academy. Slotting decisions will be made on a rolling basis and will be adjusted according to venue capacity restrictions. *

Yes, I Understand