IN ROUTINE

CF One Number

Service Number

* required

First Name

* required

Last Name

* required

Date of Birth

NUMBERS ONLY DAY MONTH YEAR

Element

*Required

Rank

*Required

Member Status

*Required

Home Mailing Address

*Required

City

*Required

Province

*Required

Postal Code

*Required

Phone Number

*Required

E-mail

* required

Reason for In Clearance

*Required

Losing Unit

*Required

Gaining Unit

*Required

Change of Strength Date (COS)

NUMBERS ONLY DAY MONTH YEAR

Any Additional Information

Willing to offer volunteer assistance on occasion when available/if suitable for the task at hand?

Yes No

Mess Dues Payment

Reg Force: I hereby authorize my Mess to deduct my Mess charges from my military pay

Reserve Mess Dues Payment

Reservist: I confirm that I have advised my orderly room to deduct my monthly Mess dues in accordance with Mess Constitution and By-Laws or I will contact my Mess to arrange payment.

Privacy Notice

I confirm that I have read the PRIVACY NOTICE.

Consent agreement

By registering to this program or activity, I consent to the collection and use of my personal information as described in the privacy notice above.

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IN ROUTINE

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