Let’s make the holidays a wonderful event!
Naval Base Kitsap First Class Petty Officer Association is calling on willing families to invite a few extra guests over for Thanksgiving.
Apply now to host your Service Members! Contact RP1 Jason Jack at: 360-396-6005 or to learn more.
Host Forms will be accepted thru
November 19, 2010
Bring a Touch of home
for
Submit your host form now!
PICK UP TIME AND PLACE:
Naval Base Kitsap Bangor
“Pass and ID” Parking Lot
Pick-up at 0830-0930
Thanksgiving Day
Thanksgiving Adopt-A-Service Member 2010
“HOST AGREEMENT” FORM
This year, Army, Navy, Marine Corps, and Coast Guard Personnel will have an opportunity to enjoy Thanksgiving dinner with local families thanks to Naval Base Kitsap’s First Class Petty Officer Association “Adopt-a-Service Member Program.” Applications will be accepted starting on October 8, 2010. ALL HOST FORMS MUST BE RECEIVED BY November 12, 2010 before 1600. Applicants will be notified on the week of November 15, 2010 if they have been accepted.
For forms, contact RP1 Jack at 360-396-6005 or
FAX the completed form to 360-396-4530
You may also email me with additional concerns or questions.
Host Restrictions:
1. Requests for Service Members of a particular racial, religious background or sex cannot be honored.
2. Requests for Service Members will be limited to (4) per family. Families must live no farther than 50 miles from Naval Base Kitsap.
3. Arrive at Naval Base Kitsap Bangor “Pass and ID Parking Lot” (OFF-BASE) no earlier than 0830 on Thanksgiving Day 25 November, 2010. Service Members must be picked up no later than 0930.
4. In case of an emergency, call Naval Base Kitsap’s Command Duty Officer at 360-396-7657 or Quarterdeck at 360-627-4024.
5. Underage drinking is strictly prohibited. It is the host’s responsibility to confirm that the Service Member is of drinking age.
PRIVACY ACT STATEMENT
AUTHORITY: Authority to request this information is found in 5 U.S.C. § 301 (Authorizing Departmental Forms and Regulations).
PRINCIPAL PURPOSE: The information you provide will be used to process your application to host a Service Member for Thanksgiving dinner as part of the Adopt-a-Service Member Program.
ROUTINE USE(S): Information you provide in this application is protected by the Privacy Act and will not be released outside the Department of Defense without your permission unless it comes within an exception to the Act or one of routine uses in 32 C.F.R § 701.112, http://www.privacy.navy.mil and the routine uses set forth here. Information will be submitted to the LEADS database to check on any criminal history of the applicant [gv1].
DISCLOSURE: Providing the requested information is voluntary. However, failure to do so may result in our inability to process your application for the Adopt-a-Service Member Program.
Host Agreement:
1. Requests for Service Members of a particular racial, religious background or sex cannot be honored.
2. Requests for Service Members will be limited to (4) per family. Families must live no farther than 50 miles from Naval Base Kitsap.
3. Arrive at Naval Base Kitsap Bangor “Pass and ID Parking Lot” (OFF-BASE) no earlier than 0830 on Thanksgiving Day 25 November, 2010. Service Members must be picked up no later than 0930.
4. In case of an emergency, call Naval Base Kitsap’s Command Duty Officer at 360-340-5335 or Quarterdeck at 360-627-4024.
5. Underage drinking is strictly prohibited. It is the host’s responsibility to confirm that the Service Member is of drinking age.
I agree to the conditions as stated on this form.
______
Signature of Host
Name of Host (First, MI, Last): ______
Address: ______
Home phone: ______
Cell phone: ______
Day Time phone: ______
E-mail: ______
Number of Service Members planning to invite: _____ (MAX 4)
You will be notified on the week of November 15, 2010 if you have been accepted by the program. Please FAX this completed form to 360-396-4530
Thanksgiving Adopt-A-Service Member 2010
“SERVICEMEMBERS’ AGREEMENT” FORM
This year, Army, Navy, Marine Corps, and Coast Guard Personnel will have an opportunity to enjoy Thanksgiving dinner with local families thanks to Naval Base Kitsap’s First Class Petty Officer Association “Adopt-a-Service Member Program”. Applications will be accepted starting on October 8, 2010. ALL SERVICEMEMBERS’ AGREEMENT” FORMS MUST BE RECEIVED BY November 12, 2010 before 1600. Service Members will be notified on the week of November 15, 2010 if they have been accepted for the program.
For forms, contact RP1 Jack at 360-396-6005 or
FAX the completed form to 360-396-4530
You may also email me with additional concerns or questions.
Service Members’ Restrictions:
1. Requests for families of a particular racial or religious background cannot be honored.
2. Arrive at Naval Base Kitsap Bangor “Pass and ID Parking Lot” (OFF-BASE) no earlier than 0830 on Thanksgiving Day 25 November, 2010.
3. In case of an emergency, call Naval Base Kitsap’s Command Duty Officer at 360-340-5335 or Quarterdeck at 360-627-4024.
4. Underage drinking is strictly prohibited. It is your responsibility to inform host if under alcohol consumption age.
Thanksgiving Adopt-A-Service Member 2010
1. I willing agree to be sponsored by a family (Host) for Thanksgiving Day.
2. If my plans change unexpectedly, I will make all reasonable efforts to contact my “designated” host.
3. I agree to represent the United States Armed Forces in an appropriate manner.
4. I agree to arrive at Naval Base Kitsap Bangor “Pass and ID Parking Lot” (OFF-BASE) between 0830 and 0930 on Thanksgiving Day 25 November, 2010 to be picked up.
5. In case of an emergency, I will call the Naval Base Kitsap’s Command Duty Officer at 360-340-5335 or Quarterdeck at 360-627-4024.
6. I am aware that Underage drinking is strictly prohibited and punishable under the UCMJ.
I agree to the conditions as stated on this form.
______
Signature of Service Member
Name of Service Member (First, MI, Last):
______
Address: ______
Work phone: ______
Cell phone: ______
Other phone: ______
E-mail: ______
Please FAX this completed form to 360-396-4530