Cadet Program Application Name* First Last PhoneAddress* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Date of Birth* Date Format: MM slash DD slash YYYY Age Today*Please enter a number from 14 to 17.Gender* Male Female Email* Do you have a High School Diploma or GED?*YesNoIf yes, School Name & address*Are you currently enrolled in...*High SchoolCollegeSelect one. Which school or college do you attend?*What is your GPA?*Have your participated in the KCR Cadet Program before?*YesNoWhere?*Where did you hear about the Cadet Program?*Please give a brief description of where you heard about the Cadet Program.Do you have a TN Driver’s license?*YesNoDL#Additional InfoList any extracurricular activities*Do you have any physical limitations, medical considerations, health concerns or special needs?*****Special needs will not automatically disqualify you from participation with the Cadet Program.****Have you ever been arrested and/or convicted of ANY crime other than traffic violations?*YesNoIf yes, please explain. Attach any documents if necessary.*List all traffic citations received in the last 3 years & the outcome of these violations.*Emergency Contact InfoIn the event of an emergency or serious injury/ illness, this information will be used to notify your parent/guardian obtain consent if needed.Name* First Last Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Primary Phone Number*Secondary Phone NumberWaiver and Release of LiabilityWaiver and Release of Liability*Please use the following link, or copy and paste into your browser, to print the Waiver and Release of Liability for your parent(s) to complete. https://knoxcountyrescue.org/wp-content/uploads/2021/01/Cadet-waiver.pdf By checking this box, I confirm that I have printed the below Waiver and Release of Liability for my parent(s) to complete. Δ Share this:TwitterFacebookLinkedInEmail