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NAVY YOUTH SPONSORSHIP REQUEST FORM
YOUTH'S INFORMATION
*
Indicates required field
Name
*
First
Last
Please submit your full first and last name
Gender
*
Select One
Female
Male
Nonbinary
Prefer not to say
Please select your gender
Birth Date
*
MM/DD/YYYY
Grade
*
Select One
3rd
4th
5th
6th
7th
8th
9th
10th
11th
12th
School Attending
*
Unknown
Charles Barnum Elementary
Mary Morrison Elementary
Pleasant Valley Elementary
S.B. Butler Elementary
Northeast Academy
Catherine Kolnaski Magnet School
Claude Chester Elementary
West Side Middle School
Cutler Middle School
Fitch High School
Gales Ferry Elementary
Juliet Long Elementary
Gallup Hill Elementary
Ledyard Center School
Ledyard Junior High School
Ledyard High School
Waterford School District
New London School District
Stonington School District
East Lyme School District
Norwich School District
Montville School District
North Stonington School District
Preston School District
LEARN/Magnet School (Please Specify Below)
Private School (Please Specify Below)
Other School (Please Specify Below)
Please select the school you will be attending once you have moved to the area
Estimated Date of Arrival
*
MM/DD/YYYY
SPONSOR'S INFORMATION
Sponsor's Name
*
First
Last
Sponsor's Email
*
Primary Phone Number
*
Alternate Phone Number
*
Spouse's Name
*
First
Last
Spouse's Email
*
Spouse's Phone Number
*
What Additional Information Would You Like to Know About the Community?
*
YOUTH'S HOBBIES & INTERESTS (please select all that apply)
SPORTS
*
Baseball/Softball
Basketball
Bowling
Cheerleading
Football
Golf
Gymnastics
Judo/Karate
Running
Soccer
Swimming
Other:
*
MUSIC
*
Alternative/Indie
Classic Rock
Country
Gospel
Metal
Hip-Hop/Rap
Pop/Top 40
R&B/Soul
I Play An Instrument:
*
CLUBS/PROGRAMS
*
4-H Club
Career Launch
FitFactor
Goals for Graduation
Keystone Club
SmartMoves
Teen Tech Team
Torch Club
Other:
*
OTHER
*
The Arts
Cooking
Dancing
Drama
Fitness
Nature/The Outdoors
Painting
Photography
Other:
*
Privacy Act Statement
Authority
: 5 USC 301, 44 USC 3101
Purpose
: To apply for permission to participate in MWR activities.
Usage
: To maintain information on participants, some of which may be used in cases of emergencies.
Disclosure
: Disclosure is voluntary. Failure to provide the requested information may result in denial of permission to participate in MWR activities.
If you would rather download, print, and mail or fax the form, please click
HERE
.
Submit
Home
Join Our Team
Upcoming Events
Child Development Center
Infants
Pretoddlers
Toddlers
Preschool
Youth Center
School Age Care Program
Youth & Teens
Youth of the Year
Parent Resources
Additional Resources
CYP Parent Handbook
Developmental Milestones
Registration Information
Parent Education
Trainer Tips & Tricks
School Liaison
Local School Options
>
Elementary Schools
Middle Schools
High Schools
Home schools
Preschool Programs
Youth Sponsorship Program
>
Youth Sponsor Submission Form
Youth Welcome Guide
Meet Our Mentors!