Leavenworth JROTC

Initial BriefingAS OF SY 15-16

OUR MISSION: To Motivate Young People to be Better Citizens The acronym JROTC means:

J-JuniorR-ReserveO-OfficersT- TrainingC- Corps

Motto: “Primus in Patria” - First in the Nation Slogan: “Others before Ourselves”

BENEFITS OF JROTC

1. 4 Year program2. 180 hours required per year3. One credit toward graduation each successful semester4. Scholarship to Colleges and Universities available from all services

(see SAI)5. Appointment to U.S. Military Academy at West Point6. JROTC is an elective course open to all grade levels. It is an

alternative to Sophomore, Junior, or Senior PE.7. Enlistment in the service one grade higher than those who have not

had JROTC. After successful completion of three years individual can enter the service at the rank of E-2. (Recommendation by SAI)

FIVE DEVELOPMENTAL AREAS

1. Citizenship 4. Physical Fitness2. Leadership 5. Sociability3. Academics

ORGANIZATION

JROTC consists of a student-run battalion broken down into six companies, each with two platoons. There

are three squads in each platoon.

SPECIAL TEAMS

Academic Team Leadership TeamCannon Crew RaidersChorus Rifle TeamColor Guard Saber TeamDrum & Bugle Junior GuardPioneer Guard Cavalry Angels

SPECIAL TEAMS

• SPECIAL TEAM ELIGIBILITY: Cadet Command Regulation 145-2, paragraph 3-15 c states that cadets must maintain an acceptable standard of academic achievement and standing. Additionally, paragraph 9-13 states that cadets participating in special teams must have and maintain a minimum of a 2.0 grade point average. If cadets do not meet this requirement, they are not allowed to participate on a special team. This means in order to be on the team the cadet must have achieved a 2.0 or better during the previous semester.

• Additionally, if a cadet has an F in power school during the current

semester, they are not allowed to travel with or compete/perform with the team.

RAIDER

CAVALRY ANGELS & PIONEER GUARD

COLOR GUARD

RIFLE TEAM

CANNON CREW

DRUM & BUGLE CORPS

JUNIOR GUARD

SABER GUARD

CADET CHORUS

CLASS ROOM PROCEDURES AND CONDUCT

-Be on time.-Do not depart classroom without permission by AI/SAI.-Stand by your seat. Do not sit down until told to do so.-No chewing gum. Dispose of gum before entering the JROTC area.-No eating or drinking unless approved by AI/SAI.-When name is called answer “Here” in a strong voice. Utilize proper

military courtesy (Sir/Ma’am).- Respect your company leadership-Do not talk unless given permission by person in charge.-No talking when a person is speaking in front of class, if you have a

question raise your hand.-Do not write on the desks.-Show respect to everyone. Respect, respect, respect.-Be honest, be reliable, take responsibility for your actions.

GRADING SYSTEM

Academics: 25%Uniform: 25%Participation: 20% = 100 points to start than take off the following points

Tardy – 2 pointFailure to Participate example: PT/DRILL = minus 10 points

Evaluation: 10% this is your AI’s evaluation of you. We look at how you are in class, uniform wear do the required community service.

Community Service: 20%• 10 hours needed by 14 Oct for 100% • 10 hours needed by 15 Dec for 100% • 10 hours needed by 12 Mar for 100% • 10 hours needed by 18 May for 100%

NOTE: If you sign up for a community service and do not show, the hours you would have completed will be added to your total requirement for that quarter.

TARDIES• Cadets will be next to their seats when the tardy bell rings. On uniform

days they will be within the JROTC area, in one of the rooms designated for changing, at the time of the bell. Exception: First-hour students will be in uniform and next to their seats at the time of the bell. On physical training days, students will be in one of three places at the time of the bell: Next to their seats, in a designated changing area (except 1st hour), or in the designated gymnasium for the day.

• Any cadet not in one of these locations when the bell rings is considered tardy.

• 1st and 2nd tardies (in a semester) will result in counseling from the cadet chain of command and the cadre. On the 3rd, 4th, and 5th tardies, the cadet will be referred to the office for detention. The 6th, 7th, and 8th tardies will result in In School Suspension (ISS). 9 or more tardies will result in Out of School Suspension (OSS).

UNIFORM POLICYCompany points for uniform will be on uniform day only (usually

Tuesdays). The number present who have been issued a uniform will be used to determine the % in

compliance. Any uniforms left where they should not be on Wednesday afternoon will be subtracted from company total, and that individual will get a 70 (minus whatever inspection points they may have lost).

Make-ups will be for individual points only. Absent cadets can earn up to 100 points on their first day back, those that failed to wear the uniform can earn up to 70 points if they wear their uniform the next day.

All Squad leaders and above will wear the uniform all day (Leading by example).

If you have a class that you cannot wear the uniform for (i.e. Physical Education) you will change out of your uniform before that class and into your uniform following the class. You will dress-out for PE.

Supply room will be closed on uniform days.

PROMOTIONS:

Must be passing all classes, and have a C or higher in JROTC. Must have made up any missed uniform days within the first day back to

school. If not for an excused absence, the highest grade you can get on a uniform makeup is 70 points.

Must have completed all required community service hours before the promotion dates: 1st promotion cycle 15 Oct

NOTE: This cycle is for promotion from Cadet to Cadet Private only 2nd promotion cycle 16 Dec 3rd promotion cycle 29 Apr

NOTE: Ten 3rd quarter and at least four 4th quarter community service hours must be completed to be considered for this promotion.LET 1s can be promoted up to the rank of CPL – Cadet of the Year can earn an additional rank.LET 2s can be promoted to the rank of SSG – Cadet of the Year can earn additional rank. Promotions to SGT must appear in front of a promotion board (unless promotion is due to winning a cadet of the month/year board).LET 3s can be promoted to the rank of 2LT- must have appeared in front of a promotion board, be at least a SSG, pass written test, and hold an officer position.LET 4s can achieve all ranks.

RETENTION IN THE PROGRAM:

Belonging to JROTC is a privilege, and those not demonstrating our values will not be permitted to continue in the program. Any of the following circumstances will be grounds for dismissal from the program:

Nine (9) In-School Suspension (ISS) days during a single semester

Any Out-of-School Suspension (OSS) incident will trigger a review for retention in the program.

Juniors and seniors who receive two F’s in a semester. This will trigger a meeting with the student, their counselor, and their parents to determine if they are still on track to graduate.

Receiving a zero on four uniform days in a semester.

DRILLS:

FIRE DRILL PROCEDURESTORNADO DRILLSCRISIS MANAGEMENT

Personal Data Form

Personal Data FormPERSONAL DATA ENTRY

Last Name: ________________________ First Name: _____________________ MI: _____ Student ID: _____________________ Gender: Male/Female Race: _____________________ DOB: _____/_____/________ mm dd yyyy Cross Enrolled: Yes/No Cross Enrolled School: ____________________________________ Alien: Yes/No (circle yes if you are not a US citizen)

Grade: _________________ Enrollment Date: _______/_______/_________ mm dd yyyy

Expected Graduation Date: ________/________ Company: _______________________ mm yyyy Address: ___________________________________________________ Apt: ____________ City: _______________________________ State: ___________ Zip: __________________

Home Phone: ( )__________________ Work Phone: ( )____________________

Parent/Guardian Information

Name: _____________________________________ Relationship: ______________________

Address: ____________________________________________________ Apt: ___________

City: _________________________________ State: _____________ Zip: _______________

Home Phone: ( )___________________ Work Phone: ( )____________________

Name, YOUR NAMEPERSONAL DATA ENTRY

Last Name: Underhill_ First Name: Frodo________ MI: J.___ Student ID: _____________________ Gender: Male/Female Race: _____________________ DOB: _____/_____/________ mm dd yyyy Cross Enrolled: Yes/No Cross Enrolled School: ____________________________________ Alien: Yes/No (circle yes if you are not a US citizen)

Grade: _________________ Enrollment Date: _______/_______/_________ mm dd yyyy

Expected Graduation Date: ________/________ Company: _______________________ mm yyyy Address: ___________________________________________________ Apt: ____________ City: _______________________________ State: ___________ Zip: __________________

Home Phone: ( )__________________ Work Phone: ( )____________________

Parent/Guardian Information

Name: _____________________________________ Relationship: ______________________

Address: ____________________________________________________ Apt: ___________

City: _________________________________ State: _____________ Zip: _______________

Home Phone: ( )___________________ Work Phone: ( )____________________

Student ID #PERSONAL DATA ENTRY

Last Name: Underhill_ First Name: Frodo________ MI: J.___

Student ID: 12345678____ Gender: Male/Female Race: _____________________ DOB: _____/_____/________ mm dd yyyy Cross Enrolled: Yes/No Cross Enrolled School: ____________________________________ Alien: Yes/No (circle yes if you are not a US citizen)

Grade: _________________ Enrollment Date: _______/_______/_________ mm dd yyyy

Expected Graduation Date: ________/________ Company: _______________________ mm yyyy Address: ___________________________________________________ Apt: ____________ City: _______________________________ State: ___________ Zip: __________________

Home Phone: ( )__________________ Work Phone: ( )____________________

Parent/Guardian Information

Name: _____________________________________ Relationship: ______________________

Address: ____________________________________________________ Apt: ___________

City: _________________________________ State: _____________ Zip: _______________

Home Phone: ( )___________________ Work Phone: ( )____________________

GenderPERSONAL DATA ENTRY

Last Name: Underhill_ First Name: Frodo________ MI: J.___

Student ID: 12345678____ Gender: Male/Female Race: _____________________ DOB: _____/_____/________ mm dd yyyy Cross Enrolled: Yes/No Cross Enrolled School: ____________________________________ Alien: Yes/No (circle yes if you are not a US citizen)

Grade: _________________ Enrollment Date: _______/_______/_________ mm dd yyyy

Expected Graduation Date: ________/________ Company: _______________________ mm yyyy Address: ___________________________________________________ Apt: ____________ City: _______________________________ State: ___________ Zip: __________________

Home Phone: ( )__________________ Work Phone: ( )____________________

Parent/Guardian Information

Name: _____________________________________ Relationship: ______________________

Address: ____________________________________________________ Apt: ___________

City: _________________________________ State: _____________ Zip: _______________

Home Phone: ( )___________________ Work Phone: ( )____________________

Race, whatever you identify withPERSONAL DATA ENTRY

Last Name: Underhill_ First Name: Frodo________ MI: J.___

Student ID: 12345678____

Gender: Male/Female Race: Hobbit ______ DOB: _____/_____/________ mm dd yyyy Cross Enrolled: Yes/No Cross Enrolled School: ____________________________________ Alien: Yes/No (circle yes if you are not a US citizen)

Grade: _________________ Enrollment Date: _______/_______/_________ mm dd yyyy

Expected Graduation Date: ________/________ Company: _______________________ mm yyyy Address: ___________________________________________________ Apt: ____________ City: _______________________________ State: ___________ Zip: __________________

Home Phone: ( )__________________ Work Phone: ( )____________________

Parent/Guardian Information

Name: _____________________________________ Relationship: ______________________

Address: ____________________________________________________ Apt: ___________

City: _________________________________ State: _____________ Zip: _______________

Home Phone: ( )___________________ Work Phone: ( )____________________

BirthdatePERSONAL DATA ENTRY

Last Name: Underhill_ First Name: Frodo________ MI: J.___

Student ID: 12345678____

Gender: Male/Female Race: Hobbit ______ DOB: 12 _/ 12 /_1912___ mm dd yyyy Cross Enrolled: Yes/No Cross Enrolled School: ____________________________________ Alien: Yes/No (circle yes if you are not a US citizen)

Grade: _________________ Enrollment Date: _______/_______/_________ mm dd yyyy

Expected Graduation Date: ________/________ Company: _______________________ mm yyyy Address: ___________________________________________________ Apt: ____________ City: _______________________________ State: ___________ Zip: __________________

Home Phone: ( )__________________ Work Phone: ( )____________________

Parent/Guardian Information

Name: _____________________________________ Relationship: ______________________

Address: ____________________________________________________ Apt: ___________

City: _________________________________ State: _____________ Zip: _______________

Home Phone: ( )___________________ Work Phone: ( )____________________

Cross Enrolled, Yes or No?PERSONAL DATA ENTRY

Last Name: Underhill_ First Name: Frodo________ MI: J.___

Student ID: 12345678____

Gender: Male/Female Race: Hobbit ______ DOB: 12 _/ 12 /_1912___ mm dd yyyy

Cross Enrolled: Yes/No Cross Enrolled School: Lansing_________________ Alien: Yes/No (circle yes if you are not a US citizen)

Grade: _________________ Enrollment Date: _______/_______/_________ mm dd yyyy

Expected Graduation Date: ________/________ Company: _______________________ mm yyyy Address: ___________________________________________________ Apt: ____________ City: _______________________________ State: ___________ Zip: __________________

Home Phone: ( )__________________ Work Phone: ( )____________________

Parent/Guardian Information

Name: _____________________________________ Relationship: ______________________

Address: ____________________________________________________ Apt: ___________

City: _________________________________ State: _____________ Zip: _______________

Home Phone: ( )___________________ Work Phone: ( )____________________

Alien, Yes if you are not a US citizenPERSONAL DATA ENTRY

Last Name: Underhill_ First Name: Frodo________ MI: J.___

Student ID: 12345678____

Gender: Male/Female Race: Hobbit ______ DOB: 12 _/ 12 /_1912___ mm dd yyyy

Cross Enrolled: Yes/No Cross Enrolled School: Lansing_________________ Alien: Yes/No (circle yes if you are not a US citizen)

Grade: _________________ Enrollment Date: _______/_______/_________ mm dd yyyy

Expected Graduation Date: ________/________ Company: _______________________ mm yyyy Address: ___________________________________________________ Apt: ____________ City: _______________________________ State: ___________ Zip: __________________

Home Phone: ( )__________________ Work Phone: ( )____________________

Parent/Guardian Information

Name: _____________________________________ Relationship: ______________________

Address: ____________________________________________________ Apt: ___________

City: _________________________________ State: _____________ Zip: _______________

Home Phone: ( )___________________ Work Phone: ( )____________________

Grade and Enrollment DatePERSONAL DATA ENTRY

Last Name: Underhill_ First Name: Frodo________ MI: J.___

Student ID: 12345678____

Gender: Male/Female Race: Hobbit ______ DOB: 12 _/ 12 /_1912___ mm dd yyyy

Cross Enrolled: Yes/No Cross Enrolled School: Lansing_________________ Alien: Yes/No (circle yes if you are not a US citizen)

Grade: 9/freshman Enrollment Date: 08 / 13__/__2013__ mm dd yyyy

Expected Graduation Date: ________/________ Company: _______________________ mm yyyy Address: ___________________________________________________ Apt: ____________ City: _______________________________ State: ___________ Zip: __________________

Home Phone: ( )__________________ Work Phone: ( )____________________

Parent/Guardian Information

Name: _____________________________________ Relationship: ______________________

Address: ____________________________________________________ Apt: ___________

City: _________________________________ State: _____________ Zip: _______________

Home Phone: ( )___________________ Work Phone: ( )____________________

Expected Graduation, when you should graduatePERSONAL DATA ENTRY

Last Name: Underhill_ First Name: Frodo________ MI: J.___

Student ID: 12345678____

Gender: Male/Female Race: Hobbit ______ DOB: 12 _/ 12 /_1912___ mm dd yyyy

Cross Enrolled: Yes/No Cross Enrolled School: Lansing_________________ Alien: Yes/No (circle yes if you are not a US citizen)

Grade: 9/freshman Enrollment Date: 08 / 13__/__2013__ mm dd yyyy

Expected Graduation Date: 05__/_2017____ Company: _______________________ mm yyyy Address: ___________________________________________________ Apt: ____________ City: _______________________________ State: ___________ Zip: __________________

Home Phone: ( )__________________ Work Phone: ( )____________________

Parent/Guardian Information

Name: _____________________________________ Relationship: ______________________

Address: ____________________________________________________ Apt: ___________

City: _________________________________ State: _____________ Zip: _______________

Home Phone: ( )___________________ Work Phone: ( )____________________

Company, the one you are in NOWPERSONAL DATA ENTRY

Last Name: Underhill_ First Name: Frodo________ MI: J.___

Student ID: 12345678____

Gender: Male/Female Race: Hobbit ______ DOB: 12 _/ 12 /_1912___ mm dd yyyy

Cross Enrolled: Yes/No Cross Enrolled School: Lansing_________________ Alien: Yes/No (circle yes if you are not a US citizen)

Grade: 9/freshman Enrollment Date: 08 / 13__/__2013__ mm dd yyyy

Expected Graduation Date: 05__/_2017____ Company: Alpha__ mm yyyy Address: ___________________________________________________ Apt: ____________ City: _______________________________ State: ___________ Zip: __________________

Home Phone: ( )__________________ Work Phone: ( )____________________

Parent/Guardian Information

Name: _____________________________________ Relationship: ______________________

Address: ____________________________________________________ Apt: ___________

City: _________________________________ State: _____________ Zip: _______________

Home Phone: ( )___________________ Work Phone: ( )____________________

Address, YOUR AddressPERSONAL DATA ENTRY

Last Name: Underhill_ First Name: Frodo________ MI: J.___

Student ID: 12345678____

Gender: Male/Female Race: Hobbit ______ DOB: 12 _/ 12 /_1912___ mm dd yyyy

Cross Enrolled: Yes/No Cross Enrolled School: Lansing_________________ Alien: Yes/No (circle yes if you are not a US citizen)

Grade: 9/freshman Enrollment Date: 08 / 13__/__2013__ mm dd yyyy

Expected Graduation Date: 05__/_2017____ Company: Alpha__ mm yyyy

Address: _Bagend, Bagshot Row______________ Apt: ____________

City: _Hobbiton_______________ State: Shire Zip: __________________

Home Phone: (999 )__234-1234_ Work Phone: ( )____________________

Parent/Guardian Information

Name: _____________________________________ Relationship: ______________________

Address: ____________________________________________________ Apt: ___________

City: _________________________________ State: _____________ Zip: _______________

Home Phone: ( )___________________ Work Phone: ( )____________________

Parent/Guardian Address, if different from yoursPERSONAL DATA ENTRY

Last Name: Underhill_ First Name: Frodo________ MI: J.___

Student ID: 12345678____

Gender: Male/Female Race: Hobbit ______ DOB: 12 _/ 12 /_1912___ mm dd yyyy

Cross Enrolled: Yes/No Cross Enrolled School: Lansing_________________ Alien: Yes/No (circle yes if you are not a US citizen)

Grade: 9/freshman Enrollment Date: 08 / 13__/__2013__ mm dd yyyy

Expected Graduation Date: 05__/_2017____ Company: Alpha__ mm yyyy

Address: _Bagend, Bagshot Row______________ Apt: ____________

City: _Hobbiton_______________ State: Shire Zip: __________________

Home Phone: (999 )__234-1234_ Work Phone: ( )____________________

Parent/Guardian Information

Name: Gandalf________________ Relationship: _ guardian___________

Address: _Last Homely House__________________ Apt: ___________

City: Rivendell__________ State: _Middle Earth Zip: _______________

Privacy Act Statement

Privacy Act StatementLET Level _______

Sch Grade ________

Last Name, First Name, MI School Name and Address date entered JROTC Co. _________

TITLE OF FORM: PRIVACY ACT STATEMENT

PRESCRIBING DIRECTIVE: AR 145-2

AUTHORITY: TITLE 10 USC 2031

PRIMARY PURPOSE: To maintain a record of leadership training progress and extracurricular activities of a Junior ROTC Cadet.

ROUTINE USES: Used to comply with U.S. Army requirements to provide a chronological record of the cadet 's progress in Junior ROTC. Information is used to prepare the following; school transcripts, promotion / reduction orders, awards and decorations. It is also used as a record of positions held, extracurricular activities, parental permission and physical condition.

MANDATO RY O R VO LUNTARY DISCLO SURE AND EFFECT O N INDIVIDUAL NO T PRO VIDING INFO RMATIO N;

Disclosure of some information is voluntary, other is mandatory; failure to provide mandatory information would result in disenrollment from the program.

A CO PY O F THIS PRIVACY ACT STATEMENT WILL BE MADE AVAILABLE UPO N REQ UEST.

I have read the applicable portions of the Privacy Act of 1974. I have also been briefed and understand my responsibilit ies when in possession of weapons and ammunition. I further agree to accept responsibility for safeguarding, maintaining, and accounting for any government property issued to me.

(Signature of a parent or guardian also required if Cadet is under the age of 18)

_______________________________________________________________ ____________________________________________________

Leavenworth High School, 2012 10th Street Leavenworth, KS 66048

PARENT / GUARDIAN (print name) SIGNATURE DATE CADET (print name) SIGNATURE DATE

____________________________________________________

HEALTH STATEMENT

Information is used as the basis for preparing Cadet Command Form 226-R (Certificate of Training).

MY (O UR) SO N / DAUGHTER: ___________________________________________________ has no medical condition or impairment (except as noted below) that would preclude his/her full participation in the Army Junior Reserve Officer Training Corps, and has my (our) permission to participate in any and all JROTC sponsored classes, training and activities.LIMITATIO NS: _____________________________________________________________________________________________________________________________________________

TYPED OR PRINTED NAME OF PARENT OR GUARDIAN (Health Statement) SIGNATURE OF PARENT OR GUARDIAN (Health Statement)

Your NameLET Level _______

Sch Grade ________

Last Name, First Name, MI School Name and Address date entered JROTC Co. _________

TITLE OF FORM: PRIVACY ACT STATEMENT

PRESCRIBING DIRECTIVE: AR 145-2

AUTHORITY: TITLE 10 USC 2031

PRIMARY PURPOSE: To maintain a record of leadership training progress and extracurricular activities of a Junior ROTC Cadet.

ROUTINE USES: Used to comply with U.S. Army requirements to provide a chronological record of the cadet 's progress in Junior ROTC. Information is used to prepare the following; school transcripts, promotion / reduction orders, awards and decorations. It is also used as a record of positions held, extracurricular activities, parental permission and physical condition.

MANDATO RY O R VO LUNTARY DISCLO SURE AND EFFECT O N INDIVIDUAL NO T PRO VIDING INFO RMATIO N;

Disclosure of some information is voluntary, other is mandatory; failure to provide mandatory information would result in disenrollment from the program.

A CO PY O F THIS PRIVACY ACT STATEMENT WILL BE MADE AVAILABLE UPO N REQ UEST.

I have read the applicable portions of the Privacy Act of 1974. I have also been briefed and understand my responsibilit ies when in possession of weapons and ammunition. I further agree to accept responsibility for safeguarding, maintaining, and accounting for any government property issued to me.

(Signature of a parent or guardian also required if Cadet is under the age of 18)

_______________________________________________________________ ____________________________________________________

Underhill, Frodo J. Leavenworth High School, 2012 10th Street Leavenworth, KS 66048

PARENT / GUARDIAN (print name) SIGNATURE DATE CADET (print name) SIGNATURE DATE

____________________________________________________

HEALTH STATEMENT

Information is used as the basis for preparing Cadet Command Form 226-R (Certificate of Training).

MY (O UR) SO N / DAUGHTER: ___________________________________________________ has no medical condition or impairment (except as noted below) that would preclude his/her full participation in the Army Junior Reserve Officer Training Corps, and has my (our) permission to participate in any and all JROTC sponsored classes, training and activities.LIMITATIO NS: _____________________________________________________________________________________________________________________________________________

TYPED OR PRINTED NAME OF PARENT OR GUARDIAN (Health Statement) SIGNATURE OF PARENT OR GUARDIAN (Health Statement)

Date entered JROTCLET Level _______

Sch Grade ________

Last Name, First Name, MI School Name and Address date entered JROTC Co. _________

TITLE OF FORM: PRIVACY ACT STATEMENT

PRESCRIBING DIRECTIVE: AR 145-2

AUTHORITY: TITLE 10 USC 2031

PRIMARY PURPOSE: To maintain a record of leadership training progress and extracurricular activities of a Junior ROTC Cadet.

ROUTINE USES: Used to comply with U.S. Army requirements to provide a chronological record of the cadet 's progress in Junior ROTC. Information is used to prepare the following; school transcripts, promotion / reduction orders, awards and decorations. It is also used as a record of positions held, extracurricular activities, parental permission and physical condition.

MANDATO RY O R VO LUNTARY DISCLO SURE AND EFFECT O N INDIVIDUAL NO T PRO VIDING INFO RMATIO N;

Disclosure of some information is voluntary, other is mandatory; failure to provide mandatory information would result in disenrollment from the program.

A CO PY O F THIS PRIVACY ACT STATEMENT WILL BE MADE AVAILABLE UPO N REQ UEST.

I have read the applicable portions of the Privacy Act of 1974. I have also been briefed and understand my responsibilities when in possession of weapons and ammunition. I further agree to accept responsibility for safeguarding, maintaining, and accounting for any government property issued to me.

(Signature of a parent or guardian also required if Cadet is under the age of 18)

_______________________________________________________________ ____________________________________________________

Underhill, Frodo J. Leavenworth High School, 2012 10th Street Leavenworth, KS 66048 8/13/2013

PARENT / GUARDIAN (print name) SIGNATURE DATE CADET (print name) SIGNATURE DATE

____________________________________________________

HEALTH STATEMENT

Information is used as the basis for preparing Cadet Command Form 226-R (Certificate of Training).

MY (O UR) SO N / DAUGHTER: ___________________________________________________ has no medical condition or impairment (except as noted below) that would preclude his/her full participation in the Army Junior Reserve Officer Training Corps, and has my (our) permission to participate in any and all JROTC sponsored classes, training and activities.LIMITATIO NS: _____________________________________________________________________________________________________________________________________________

TYPED OR PRINTED NAME OF PARENT OR GUARDIAN (Health Statement) SIGNATURE OF PARENT OR GUARDIAN (Health Statement)

LET Level, Sch Grade, COLET Level ___1__

Sch Grade 9__

Last Name, First Name, MI School Name and Address date entered JROTC Co. _A__

TITLE OF FORM: PRIVACY ACT STATEMENT

PRESCRIBING DIRECTIVE: AR 145-2

AUTHORITY: TITLE 10 USC 2031

PRIMARY PURPOSE: To maintain a record of leadership training progress and extracurricular activities of a Junior ROTC Cadet.

ROUTINE USES: Used to comply with U.S. Army requirements to provide a chronological record of the cadet 's progress in Junior ROTC. Information is used to prepare the following; school transcripts, promotion / reduction orders, awards and decorations. It is also used as a record of positions held, extracurricular activities, parental permission and physical condition.

MANDATO RY O R VO LUNTARY DISCLO SURE AND EFFECT O N INDIVIDUAL NO T PRO VIDING INFO RMATIO N;

Disclosure of some information is voluntary, other is mandatory; failure to provide mandatory information would result in disenrollment from the program.

A CO PY O F THIS PRIVACY ACT STATEMENT WILL BE MADE AVAILABLE UPO N REQ UEST.

I have read the applicable portions of the Privacy Act of 1974. I have also been briefed and understand my responsibilities when in possession of weapons and ammunition. I further agree to accept responsibility for safeguarding, maintaining, and accounting for any government property issued to me.

(Signature of a parent or guardian also required if Cadet is under the age of 18)

_______________________________________________________________ ____________________________________________________

Underhill, Frodo J. Leavenworth High School, 2012 10th Street Leavenworth, KS 66048 8/13/2013

PARENT / GUARDIAN (print name) SIGNATURE DATE CADET (print name) SIGNATURE DATE

____________________________________________________

HEALTH STATEMENT

Information is used as the basis for preparing Cadet Command Form 226-R (Certificate of Training).

MY (O UR) SO N / DAUGHTER: ___________________________________________________ has no medical condition or impairment (except as noted below) that would preclude his/her full participation in the Army Junior Reserve Officer Training Corps, and has my (our) permission to participate in any and all JROTC sponsored classes, training and activities.LIMITATIO NS: _____________________________________________________________________________________________________________________________________________

TYPED OR PRINTED NAME OF PARENT OR GUARDIAN (Health Statement) SIGNATURE OF PARENT OR GUARDIAN (Health Statement)

Parents SignatureLast Name, First Name, MI School Name and Address date entered JROTC Co. _A__

TITLE OF FORM: PRIVACY ACT STATEMENT

PRESCRIBING DIRECTIVE: AR 145-2

AUTHORITY: TITLE 10 USC 2031

PRIMARY PURPOSE: To maintain a record of leadership training progress and extracurricular activities of a Junior ROTC Cadet.

ROUTINE USES: Used to comply with U.S. Army requirements to provide a chronological record of the cadet 's progress in Junior ROTC. Information is used to prepare the following; school transcripts, promotion / reduction orders, awards and decorations. It is also used as a record of positions held, extracurricular activities, parental permission and physical condition.

MANDATO RY O R VO LUNTARY DISCLO SURE AND EFFECT O N INDIVIDUAL NO T PRO VIDING INFO RMATIO N;

Disclosure of some information is voluntary, other is mandatory; failure to provide mandatory information would result in disenrollment from the program.

A CO PY O F THIS PRIVACY ACT STATEMENT WILL BE MADE AVAILABLE UPO N REQ UEST.

I have read the applicable portions of the Privacy Act of 1974. I have also been briefed and understand my responsibilities when in possession of weapons and ammunition. I further agree to accept responsibility for safeguarding, maintaining, and accounting for any government property issued to me.

(Signature of a parent or guardian also required if Cadet is under the age of 18)

Gandalf the Grey___________________________________________

PARENT / GUARDIAN (print name) SIGNATURE DATE CADET (print name) SIGNATURE DATE

___Gandalf the Grey____ 13 Aug 13___

HEALTH STATEMENT

Information is used as the basis for preparing Cadet Command Form 226-R (Certificate of Training).

MY (O UR) SO N / DAUGHTER: __Frodo Underhill_______________________ has no medical condition or impairment (except as noted below) that would preclude his/her

full participation in the Army Junior Reserve Officer Training Corps, and has my (our) permission to participate in any and all JROTC sponsored classes, training and activities.

LIMITATIO NS: _____________________________________________________________________________________________________________________________________________

TYPED OR PRINTED NAME OF PARENT OR GUARDIAN (Health Statement) SIGNATURE OF PARENT OR GUARDIAN (Health Statement)

Your SignatureLast Name, First Name, MI School Name and Address date entered JROTC Co. _A__

MY (O UR) SO N / DAUGHTER: __Frodo Underhill_______________________ has no medical condition or impairment (except as noted below) that would preclude his/her

full participation in the Army Junior Reserve Officer Training Corps, and has my (our) permission to participate in any and all JROTC sponsored classes, training and activities.

LIMITATIO NS: _____________________________________________________________________________________________________________________________________________

TYPED OR PRINTED NAME OF PARENT OR GUARDIAN (Health Statement) SIGNATURE OF PARENT OR GUARDIAN (Health Statement)

Gandalf the Grey___________________________________________

PARENT / GUARDIAN (print name) SIGNATURE DATE CADET (print name) SIGNATURE DATE

___Gandalf the Grey____ 13 Aug 13___ Frodo Underhill 13 Aug 13

HEALTH STATEMENT

Information is used as the basis for preparing Cadet Command Form 226-R (Certificate of Training).

MANDATO RY O R VO LUNTARY DISCLO SURE AND EFFECT O N INDIVIDUAL NO T PRO VIDING INFO RMATIO N;

Disclosure of some information is voluntary, other is mandatory; failure to provide mandatory information would result in disenrollment from the program.

A CO PY O F THIS PRIVACY ACT STATEMENT WILL BE MADE AVAILABLE UPO N REQ UEST.

I have read the applicable portions of the Privacy Act of 1974. I have also been briefed and understand my responsibilities when in possession of weapons and ammunition. I further agree to accept responsibility for safeguarding, maintaining, and accounting for any government property issued to me.

(Signature of a parent or guardian also required if Cadet is under the age of 18)

TITLE OF FORM: PRIVACY ACT STATEMENT

PRESCRIBING DIRECTIVE: AR 145-2

AUTHORITY: TITLE 10 USC 2031

PRIMARY PURPOSE: To maintain a record of leadership training progress and extracurricular activities of a Junior ROTC Cadet.

ROUTINE USES: Used to comply with U.S. Army requirements to provide a chronological record of the cadet 's progress in Junior ROTC. Information is used to prepare the following; school transcripts, promotion / reduction orders, awards and decorations. It is also used as a record of positions held, extracurricular activities, parental permission and physical condition.