Thanksgiving Adopt-A-Sailor Program
PRIVACY ACT STATEMENT
AUTHORITY:
Authority to request this information is found in 5 U.S.C. § 301 (Authorizing Departmental Forms and Regulations).
PRINCIPAL PURPOSE:
The information you provide will be used to process your application to host a Sailor for Thanksgiving dinner as part of the Adopt-a-Sailor Program.
ROUTINE USE(S):
Information you provide in this application is protected by the Privacy Act and will not be released outside the Department of Defense without your permission
unless it comes within an exception to the Act or one of routine uses in 32 C.F.R § 701.112, and the routine uses set forth here.
Information will be submitted to the LEADS database to check on any criminal history of the applicant [gv1].
DISCLOSURE:
Providing the requested information is voluntary. However, failure to do so may result in our inability to process your application for the Adopt-a-Sailor Program.
Name of Host (First, MI, Last): ______________________________________
Address: _______________________________________________________
City/State/Zip: ___________________________________________________
Home Phone: ________________________ Cell: _____________________
E-mail address: __________________________________________________
Driver’s License Number and State: __________________________________
Host Agreement and Details:
1. Requests for Sailors of a particular racial, religious background or sex cannot be honored. However, it
may be helpful to note if you will be serving a particular ethnic food or a particular diet, (i.e. Vegetarian,
Kosher, etc.), and we will try to match those with Sailor’s preference.
2. Host families agree to host two to four Sailors. Requests for Sailors will be limited to a max of four per family.
3. Arrive at the Visitor's Center no earlier than 7:30 a.m. on Thanksgiving Day. Pick Up Time: 7:30 a.m. -
8:30 a.m. Sailors must be picked up no later than 8:30 a.m. on Thanksgiving Day, November 23, 2017
at the Visitor's Center, located at Gate 1 at 610 Farragut Ave, Great Lakes, IL.
4. Sailors are required to be back in their quarters at the base no later than 10:00 p.m. Because they will have to
walk from drop-off gates, please have Sailors at the gate no later than 9:30 p.m.
5. In case of an emergency or late return call the Command Duty Officer at (847) 688-3536.
6. Underage drinking is strictly prohibited. It is the host’s responsibility to confirm the Sailor is of age.
7. Will your family be serving a particular ethnic food or a particular diet? Yes ____
No____
If so, state your dietary preference here: ____________________________________________
On Monday, November 13, 2017, Training Support Center, Great Lakes will conduct a lottery so that
everyone can have a fair chance to host a Great Lakes Sailor. Host families will be notified by email or
telephone after Wednesday, November 15, 2017 if you have been accepted by the program. You may call
the Public Affairs Office at (847) 688-4862, ext. 161, Monday - Friday, 8 a.m. to 3 p.m. with any additional
questions.
FAX or EMAIL the completed form to (847) 688-3568 or (email) to: M_GRLK_TSC.GreatLakes@navy.mil
All Host Forms MUST BE RECEIVED BY Monday, October 30, 2017.
Very Important: Please ensure that driver brings a copy of this request along with a valid driver’s license
in order to pick up Sailors. Drivers not in possession of this request form and driver’s license may forfeit
privilege of adopting Sailors.
I request to sponsor ______________ Sailors.
I agree to all the conditions as stated on this form.
(Enter 2, 3 or 4)
___________________________
______________
Signature of Host
Date
KEEP A COPY OF THIS FORM FOR YOUR INFORMATION.
TSC-GL 1710/1 (Rev. 10/17)