Pentagon Tour 05/05/05

PLEASE PRINT CLEARLY. Illegible entries will be discarded, and you will be required to stay at school and complete a worksheet on the day of the field trip.

Full name (NO INITIALS):

______________________ ______________________ ______________________

first middle last

Date of birth:

______________________ ______________________ ______________________

month day year

City and state of birth (or city and country if you were born overseas)

______________________ , ______________________

U.S. citizen? Circle one: YES NO

If U.S. citizen, enter social security number: ______ - _____ - __________

Otherwise, enter nationality _____________ and passport number: ________________________

------------------------------------------------------------"------------------------------------------------------------

Pentagon Tour 05/05/05

PLEASE PRINT CLEARLY. Illegible entries will be discarded, and you will be required to stay at school and complete a worksheet on the day of the field trip.

Full name (NO INITIALS):

______________________ ______________________ ______________________

first middle last

Date of birth:

______________________ ______________________ ______________________

month day year

City and state of birth (or city and country if you were born overseas)

______________________ , ______________________

U.S. citizen? Circle one: YES NO

If U.S. citizen, enter social security number: ______ - _____ - __________

Otherwise, enter nationality _____________ and passport number: ________________________