CADET APPLICATION
FOR OFFICIAL USE ONLY
U.S. NAVAL SEA CADET CORPS
U.S. NAVY LEAGUE CADET CORPS
REQUEST FOR ACCOMMODATION
INSTRUCTIONS
Complete this form ONLY when an accommodation is requested for a prospective cadet under the Americans with Disabilities Act
1. UNIT INFORMATION
1a. Unit Name
1b. Region
1c. Date of Request (DD MMM YY)
1d. Full Name and Rank of Commanding Officer
1e. Commanding Officer’s Phone Number
1f. Commanding Officer Email Address
2. CADET INFORMATION
2a. Last Name
2b. First Name
2c. Ml
2d. Age
2e. Parent/Guardian Names(s)
2f. Parent/Guardian(s) Phone Number
2g. Parent/Guardian(s) Email Address
3. ASSESSMENT (Completed by Parent/Guardian with assistance of the Unit Commanding Officer)
My Son/Daughter’s disability is (optional):
4. ACCOMMODATION
I am requesting the following accommodation for my son/daughter:
5. DETERMINATION
If Unit Commanding Officer determines accommodation is considered not reasonable, or cannot be made, Unit Commanding Officer must so state, with firm reasons and
further forward to the Regional Director for review/comment and NHQ Representative for final determination. Reason for not approving is:
6. ACCOMMODATION PLAN
If Unit Commanding Officer agrees, the plan of accommodation based on individual assessment to allow enrollment and participation, agreed to by all parties, is (be
specific as to can do’s, and can’t do’s, limitations, escorting requirements, Recruit Trainings and advanced training, and alternate activities/events, etc. Note: Plan can be
modified/adjusted/refined at any time.):
PREVIOUS EDITIONS ARE OBSOLETE
NSCADM 001 (Rev 08/14), Page 9
Formerly NSCADM 015