International Exchange Cadet Application Form

THE MARINE SOCIETY AND SEA CADETS
FORM
SCC T14
INTERNATIONAL EXCHANGE CADET NOMINATION FORM
Please ensure that you complete this form using capitals and in black ink.
This form should only be completed by Cadets and those nominating cadets to take
part on an International Exchange during 2015. There are opportunities available to visit
Australia, Bermuda, Canada, Hong Kong, Japan, Sweden, South Korea and USA.
Cadets will be allocated to any one of the exchanges and must be prepared to go where
allocated. Parents/guardians must acknowledge that cadets may be required to travel
through London unsupervised.
Please
attach
passport sized
photo here
Please indicate on the form if you will be unable to attend particular dates due to exam periods, prior commitments etc.
Personal Details
*Where indicated please ensure the information that you provide is exactly what is in your passport
Surname*
Forename/s*
Name which you prefer to be known as
Rank/Rate
SCC Unit
Date of Birth*
SCC Area
Place of Birth*
Male/Female
Passport Number*
Place of issue of passport*
Passport Expiry Date*
Date of Passport issue*
Blood Group
Nationality*
Contact Details
Full Home Address
Post Code
Home Phone Number
Mobile Phone Number
Email Address
Name of Next of Kin
Relationship to Applicant
Home Address
Post Code
Home Phone Number
Email Address
Mobile Phone Number
To be completed by the Cadet
Why Do You think you should be selected to participate on an international exchange
programme? Are there any Countries listed that interest you? Are there any Countries that you do not want to be selected
for?
Please list any dates you are unable to attend (e.g school exams, holidays)
I understand that if selected I will need to complete a day to day diary to record my
experience on the exchange.
Printed name of Cadet
Signature of
Cadet
Parent / Guardian Consent for cadets placement and all travel arrangements. By signing this form I give
consent for my child to travel through London unescorted. I also acknowledge that by applying for this programme
a £1000 (or £500 for Sweden) contribution will be required. NB cadets who need bursaries are to write to the
exchange officer at complete a bursary form. Please contact [email protected] for more information
Printed Name of Parent/
Guardian
Signature of
Parent/Guardian
Qualifications and Hobbies (Please attach a copy of your SCC qualifications from Westminster)
Medical and Dietary Information
Do you have any medical conditions or allergies the MSSC should be aware of? I.e. Asthma,
diabetes etc.
If yes, please specify including any medication needed
Do you have any special dietary
requirements? I.e. Vegetarian, Halal, Diabetic,
allergies
If yes, please specify:
Yes □
No □
To be completed by the Commanding Officer
Why Do You think this Cadet deserves to be
nominated?
Commanding Officer Endorsement
Printed Name and Rank of
Commanding
Officer
Signature of
Commanding Officer
Please return completed forms directly to the International Exchange Coordinator either by post or email.
Applications are to arrive no later than Monday 26th January. Applications received after this date will not be
accepted.
International Exchange Coordinator
Nicola Martin
The Marine Society and Sea Cadets
202 Lambeth Road
LONDON, SE1 7JW
Fax: 020 7928 8914
For further information please contact the International Exchange Coordinator, Nicola Martin at MSSCHQ on:
0207 654 7045
[email protected]