New Member Information Night Reservation
Please fill out the following form as accurately as possible and carefully take note of the directions on each question. Click the "Submit" button when you are finished. Every person attending must fill out the form separately. Be sure to register no later than fifteen days prior to your selected date. The last two questions are optional but are valuable for us to better serve you. Thank you for your interest in the Civil Air Patrol!
Last Name, First Name, Middle Initial *
Full Last Name, First Name, and Middle Initial in that format. This must match what is shown on your official identification.
Your answer
Birth Date *
Please enter your birth date in MM/DD/YYYY format.
MM
/
DD
/
YYYY
Drivers License or State ID Number *
Please include the Drivers License or State ID Number for people age 16 or older. This is necessary to complete the base's background check to allow you onto the installation. If you do not have either of these, you will need to obtain at least a State ID from your State's BMV before signing up. If you are under 16 years of age, please enter "N/A" into the field.
Your answer
Confirm Drivers License or State ID Number *
Please confirm your Drivers License or State ID Number for people age 16 or older. If you are under 16 years of age, please enter "N/A" into the field.
Your answer
Drivers License or State ID Issuing State *
If age 16 or older, which State issued the Drivers License or State ID? This is necessary to complete the base's background check to allow you onto the installation. If you are under 16 years of age, please enter "N/A" into the field. If you are a Pennsylvania resident, you must call Lt Col Benjamin Kulper at (330) 716-4005 and provide your social security number due to additional background check system requirements for Pennsylvania residents.
Your answer
Reason for Attending *
Please indicate if you are a potential Cadet (youth member aged 12-18), potential Senior Member (adult member over the age of 18), or a driver of a potential member.
Potential Member Attending With *
Please indicate which potential member you are attending with or will be driving to meetings. If this reservation is for yourself as a potential Cadet or Senior Member, please enter "Self" in the field below.
Your answer
Select Date *
Choose your date from this list. Be sure to register no later than fifteen days prior to your selected date.
E-mail Address *
Please provide a reliable e-mail address we can contact you at. This is needed to provide you important information regarding policies when entering the Youngstown Air Reserve Station and should be checked regularly for any necessary updates in the weeks prior to them meeting.
Your answer
Confirm E-mail Address *
Please confirm your reliable e-mail address we can contact you at.
Your answer
Gender *
Form Data Certification *
I have checked over the information above and it is correct and complete. If any information is entered incorrectly, it could delay or prevent you from access to the Youngstown Air Reserve Station.
How did you find out about the Civil Air Patrol?
This is optional, but your answer is of great value to us.
Your answer
Why are you interested in joining?
This is optional, but your answer is of great value to us.
Your answer
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