Base Pass Entry Form

Please complete the following bass pass information. Children under 16 years of age do not have to be listed. If a person does not have a Drivers License then they must list their State or Federal issued ID number. In order to be listed as a driver on base you must have current registration, proof of insurance card and valid Driver’s License.

 

Once completed hit submit button below.  Do not print and return to school office.

Your child must have a physical dated no later than 1 Mar 2011 on file in the school office by 1 Sep.*

Last Name*

First Name*

Age*

Drivers License Number*

State Issued. Two Letters Only*

Change if not NC
Date of Birth MM/DD/YYYY*

Vehicle Plate Number*

Vehicle Plate State. Two Letters Only*

Change if not NC
Driver of Vehicle*