29 Mar 2017 Shadow Day Registration
Air Force ROTC Det 595
*** All forms due by = 24 Mar 2017 ***
(PRINT LEGIBLY)
1. Student Name: ______
Last First MI
2. Gender: M / F (circle) Current Grade: 9 / 10 / 11 / 12/ 1yr college/ 2yr college (circle)
3. High School Name/College Name: ______
4. Your Contact Info: a. Phone: (_____) ______- ______(preferably cell phone)
b. E-mail: ______
5. Emergency Contact Info: a. Name: ______
b. Relation: ______
c. Phone: Daytime (______) ______- ______
Evening (______) ______- ______
6. Special Considerations. Do you have any special health-related needs that we should consider?
(i.e. allergies)
YES / NO (circle)
If YES, please explain so that we can work to accommodate your needs: ______
7. Academic Interests: Which of the following Universities are you interested in attending?
___North Carolina State University
___William Peace University
___Shaw University
___Meredith University
___Saint Augustine’s University
___Other ______
8. Additional Comments. Please let us know if you have any additional questions or comments. ______
9. Shadow Day Rules.
A. Be respectful of others.
B. Your host cadet must know where you are at all times.
C. Be safe and responsible. (Absolutely NO drugs and/or alcohol.)
D. Have fun! Ask questions and make the most of your time with Det 595.
E. No JROTC uniform.
I plan to attend Shadow Day and have read agree to follow the Shadow Day rules.
(must sign to register)
______
Signature Date
10. **Registration Deadline** Make sure Det 595 has your registration form no later than 20 Mar 2017.
To submit your registration: you can either (1) fax it, (2) scan & email it, or (3) mail it in.
(1) Fax: (919) 515-4456
(2) E- mail:
(3) AFROTC
North Carolina State University
Attn: Cadet Dieffenbach
Campus Box 7380
Raleigh, NC 27695
We will send you a confirmation e-mail. If you do not receive that confirmation e-mail, then let us know because we may not have received your registration form.
11. Excused Absence. An excused absence form can be found on the Det 595 Shadow Day Webpage. If you are unable to download this form, please let us know and we will email it to you. You should take the letter to your school prior to 29 Mar 2017 so they may consider excusing your absence for that day.
12. Parking. Parking is available and it is recommended that you park in the Cates Ave/Coliseum Deck. It is $10 for the day. Additional parking is available in the Dan Allen Deck.
13. Additional Info. Bring the following items with you:
A. Valid photo ID
B. $$$ (cash) for parking, lunch on campus, and any other personal needs
C. Athletic clothing to change into for a Physical Training session
Arrival Location/Time: Reynolds Coliseum at 7:30 A.M.
Driving directions will be e-mailed to you upon request. If you would like to receive directions, simply reply to your confirmation e-mail and let us know.
Parents are welcome to join their son/daughter for the Informational Session (briefing) in Reynolds Coliseum from 8:00 to 9:00 A.M. However, we do require that if parents are attending, please indicate that in Section 8 of this form so that we may accommodate.
Air Force ROTC stresses professionalism and you will be meeting with Air Force officers and ROTC cadets…so please arrive in a timely manner, wear appropriate clothing (i.e. nothing too revealing or offensive to others), and be mindful of your conduct. Throughout the course of Shadow Day, you will have the opportunity to attend AFROTC classes, tour academic buildings, and enjoy lunch at a campus dining facility or food court. Please do not wear your JROTC uniform!
14. Contact. Please contact Cadet Matt Dieffenbach with any questions at medieffe@ncsu.