Bengal Battalion Cadet Data Sheet

Last Name (Cadet):__________________First: __________________MI:____________

DOB: ___//___//____ Gender: (Circle ) Male / Female Student ID: #______________

Mo dd yyyy (look on your schedule)

Race: (Circle One) - African American, American Indian, Asian, Caucasian, Hispanic, Native Indian, Pacific Islander, Other

Number of Times/Semesters Successfully Completed JROTC #:__________

US Citizen: (Circle one) YES / NO

Cadet Home Address: Street:____________________________ Apartment #_______

City:____________________________, State:________ ___Zip:__________________

Home Phone:(___)______________Work:(___)____________Cell: (___) ____________

School Year (Graduation): 20_____ Enrolled: (New school year) _____//____//______

mo dd yyyy

(1) Parent/Guardian Name: ______________________________________________________________

Relationship: __________________________________________________________________________

Street:______________________________________________Apartment ________________________

City:_______________________________State:________________Zip:__________________________

Home Phone: ( ) _______________ Work: ( )_____________Cell: ( ) ___________________

US Citizen: (Circle one) YES / NO

(2) Parent/Guardian Name: ______________________________________________________________

Relationship: __________________________________________________________________________

Street:______________________________________________Apartment ________________________

City:_______________________________State:________________Zip:__________________________

Home Phone: ( ) _______________ Work: ( )_____________Cell: ( ) ___________________

US Citizen: (Circle one) YES / NO

-----------------------------------------------------------To Be filled Out by Instructors Only: -----------------------------------------------------

Let Level: __________ Company: ___________________

Platoon:_____________ Squad:_____________________