Cadet/mentor Post-Residential Contact Form
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2Cadet/Mentor Post-Residential Contact Form
YOUR Name:
Date :
CURRENT EMAIL:
Circle one - I am the:
Cadet
Mentor
Cadet ______________________________Class # _____
(Cadet's Name)
Mentor Contacts
Has the Graduated Cadet spoken to his/her mentor?
Yes
or
No
How Many times per month?
1
2
3
4
5
More than 5
Please list the dates:
What was the reason for speaking to the Mentor / Mentee?
How was the contact made (a meeting, phone, e-mail etc.)?
Placement Information
Work/Volunteer
Is the Cadet Currently Working / Volunteering?
Yes
or
No
Who is the Supervisor?
Who is the Employer?
Date of Hire:
Full-Time or Part-Time?
Hours per week:
Pay per hour:
*Please submit a copy of Cadet's pay check stub or a letter from the Supervisor (including a business card) with this
information form, to verify that the he/she is working.
Education
Is the Cadet currently attending classes?
Yes
or
No
School type (example: 2 yr, 4 yr, VoTech):
Name of school:
Status (enrolled etc)
Cadet is majoring in:
Start date:
End date:
*Please submit a copy of Cadet's class schedule and acceptance letter with this information form, to verify that he/she is
attending classes.
Military
Is the Cadet currently in the Military?
Yes
or
No
What is his/her status?
____ Active
_____National Guard
_____ Reserve
What Branch?
____ ANG
_____ ARNG
_____ USA
_____USAF
_____USCG
_____ USMC
_____ USN
Enlistment Date:
Delayed Entry Date:
Discharge Date:
*Please submit a copy of Cadet's Enlistment paperwork with this information form, to verify that he/she is in the Military.
If there are any changes in mailing addresses or phone numbers, please anotate below:
Address:
Cell Phone
Home Phone
If the Cadet had changes to the PRAP please list the specific changes; the cadet’s expected outcome as a result of the changes;
why the cadet made the changes; and the mentor’s position and rationale regarding the changes. Please attach changes.
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