Form 799-2 - Nj National Guard Non-Resident Application Page 2

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NAME:
RANK________SSN________-_______-__________
HOME ADDRESS: ______________________________________________________________________________________________________
CITY: _______________________________________________STATE:__________ZIP:________________________U.S. CITIZEN:__________
NJ NATIONAL GUARD UNIT:________________________DRIVER LICENSE NUMBER:_________ _________ _________STATE:_______
DATE OF BIRTH: MM ____ DD ____ YY ____ CONSERVATION ID NUMBER (CID): _____________________________________________
TELEPHONE NUMBER: ____________________________________________DO YOU INTEND TO HUNT SMALL GAME: ______________
HOW MANY DAYS DID YOU FISH LAST YEAR: ______________
DO YOU INTEND TO HUNT WITH A CROSSBOW: ______________
SIGNATURE: ______________________________________________________________________ DATE: ______________________________
NJDMAVA Form 799-2
01 February 2016

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