Shark Battalion Cadet Personal Data Entry Form
SY 2013-2014

	Last Name: ___________________________	First Name: ________________________	MI: _____

	ID: _____________________ 	Birth Year: _________	 Month:	Jan Feb Mar Apr May Jun
	Jul Aug Sep Oct Nov Dec
	Gender: Male Female	Race: A/B/CAU/H/I/O    Status: ACTIVE
				     
	Magnet Cadet: No

	Alien:	Yes  No

	Street: __________________________________________	Apartment: _________

	City: ______________________________________	State: _______	Zip: __________-________

	Home Phone:	(_______ )   _____________________________ Work Phone: (_______ ) __________________________________

	Home Phone Listed:	Yes  No	eMail:__________________________________________________

	School Year: __________________	Enrolled: ___	/____/________
	   mm / dd /  yyyy

	Expected Graduation Date: ____	/____/________	Type:	 CADET
	     mm / dd /  yyyy     
	Battalion: __________________	Company: ________________

	Platoon: ____________________	Squad: _________________

	Parent/Guardian Information

Name: ______________________________ Relationship: ____________	 Legal Residence: Yes No

Street: __________________________________________	Apartment: _________

City: _______________________________________ State:________	Zip:_________-__________

Home Phone:	(________ )  __________________________  Work Phone: (________ ) __________________________

Home Phone Listed: Yes  No    e-mail: _____________________________________________

Name: ______________________________ Relationship: ____________	 Legal Residence: Yes No

Street: __________________________________________	Apartment:_________

City: _______________________________________ State: ________	Zip:_________-__________

Home Phone:	(________ )   __________________________  Work Phone: (________ ) __________________________

Home Phone Listed: Yes  No    e-mail: _____________________________________________

Emergency Contact: ____________________________________________________________________

Relationship:  ____________________________  	   Phone: (_______)____________________