Prospective Candidate Information Survey
First & Last Name:
Cell Phone #:
Wentworth Institute of Technology
Massachusetts College of Pharmacy and Health Sciences
Mass Maritime Academy
Bunker Hill College
Not in school
Air Force ROTC
Navy / Marine ROTC
Are you current/prior service military?
Check any of the following that you have participated in:
Civil Air Patrol
Boy/Girl Scouts (or similar)
Outward Bound (or similar)
Other Pershing Rifles Company
What is your immediate career goal after graduation?
Explain your current level of physical fitness:
Why are you interested in Pershing Rifles, and what would you expect to get out of it?
Explain some of your weaknesses:
Do you have any experience in any of the following?
Group Leadership Responsibility
Organizational Staff Member
Urban Escape & Evasion
Basic Land Navigation
Advanced Land Navigation (without a compass or protractor)
Night Land Navigation
Backcountry GPS Usage
Wilderness Living & Survival
Rappelling and/or Rock Climbing
Instructing/Training (any discipline)
Pre-Hospital Emergency Medicine
Why do you think A-12 Pershing Rifles would want you as a member?
What (or who) prompted your interest in Pershing Rifles?
Tell us anything else that you think we should know about you, including whether you will (or may) attend Initial Boards:
Are you participating in a formal athletic program at your school?
Will you be attending an information session?
05 December 2018 (1945 at Northeastern University)
09 December 2018 (1900 at Boston University)
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