Form 799-1 - Nj National Guard Resident Application Page 2
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2MAIL APPLICATION AND LES SHOWING ACTIVE TRAINING WITHIN PAST 90 DAYS TO:
NJ DEPARTMENT OF MILITARY AND VETERANS AFFAIRS, PO BOX 340, TRENTON NJ 08625-0340
ATTN: MSG (RET) ROBERT J. GRECO (IASD-ASB-RALV)
robert.greco@dmava.nj.gov
/ FAX: 609-530-7193
NAME:
_____RANK________SSN________-_______-__________
LAST
FIRST
MI
HOME ADDRESS: ______________________________________________________________________________________________________
CITY: _______________________________________________STATE:__________ZIP:________________________U.S. CITIZEN:__________
DATE OF BIRTH: ______ MONTH _____ DAY __________ YEAR
NJ NATIONAL GUARD UNIT:________________________DRIVER LICENSE NUMBER:_________ _________ _________STATE:_______
DFW CONSERVATION IDENTIFACATION 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 799-1
01 February 2016
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