28 March 2012
Subj:
CLYDE AUSTIN 4-H CAMP GREENEVILLE, TN LEADERSHIP
ACADEMY/BASIC LEADERSHIP TRAINING LETTER OF
INSTRUCTION (LOI)
Ref:
(a) CNETINST 1533.9K
(b) NAVEDTRA 37119-C “2001 Leadership Academy Management Plan”
(c) NAVEDTRA 37122-C “2001 Leadership academy Cadet Guidebook”
Encl: (1) Information Sheet for Leadership Academy 2012
(2) Sea Bag check list
(3) Leadership Academy Registration Payment Form
(4) Standard Release Form (w/Privacy Act)
(5) Health Screening Questionnaire
(6) Academy Cadet Statement of Agreement
(7) Graduate Cadet Aide Statement of Agreement
(8) Arrival, Check-in and Departure Procedures
(9) Leadership Academy, MEDICAL FORM
(10) Directions to UT Clyde Austin 4-H Center
1. Discussion.
Cocke County High School shall sponsor an NJROTC Leadership Academy/Basic
Leadership Training (LA) IAW references (a) through (c). SNSI/NSI’s are required to be
familiar with the contents of references (a) through (c), and this LOI. Enclosures (1)
through (8) are forwarded regarding the forthcoming Leadership Academy to be held at
Clyde Austin 4-H Camp Greeneville, TN. The period of training is 5-8 July 2012.
Enclosure (1) should be distributed by the NSI to all prospective attendees and parents
which provides general overall information on the LA for both cadets and
parents/guardians. Enclosure (2) lists mandatory and recommended sea bag items to
bring to LA. Enclosure (3) shall be submitted by the Senior Naval Science Instructor of
each participating NJROTC unit to register his/her unit’s participation. Enclosures (4)
through (7) must be completed and signed as appropriate for all participating cadets.
Enclosure (8) is provided to facilitate arrival and departure. Enclosure (9) medical form
is for the Leadership Academy medical personnel.
Registration for all participants is accomplished by submitting enclosures along with
payment of $100 for each participant – NSI/instructor, cadet, cadre – checks payable to
Cocke County NJROTC and mailed to Cocke County NJROTC Unit 216 Hedrick Drive,
Newport, Tennessee 37821 to be received by COB 15 June 2012. After 2 July 2012
REFUNDS for cancellations CANNOT be made due to contractual agreements.
Payment for all other participants shall be made by school check or money order.
Receipts for participation shall be provided at the Leadership Academy Administration
Office.
Enclosures (3), (4), (5), (6) and (9) for cadets and Enclosures (4), (5), (7) and (9) for
Cadre along with a copy of each cadet’s sports physical must be received by Cocke
County NJROTC by cob 15 June 2012.
____________________________________________________________________
Following guidance and remainder of this LOI (minus attachments) is provided for
attending SNSI/NSI’s for purpose of ensuring safe cadet training evolutions conducted as
part of this particular LA:
Instructors are reminded that their specific unit NJROTC cadets are not
active duty military members. The typical cadet, just 14-17 years of
age, must be properly supervised and safeguarded at all times
particularly during training events such as this LA. The exercise of
due care, expected of a prudent person, is required anytime cadets are
conducting training. NJROTC cadets should never be intentionally
exposed to high risk training evolutions. If a potentially dangerous
situation arises, instructors will take immediate corrective action or
suspend the training until appropriate corrective action can be
determined and implemented.
It is further emphasized here that this specific cadet training
event/LA is a school-sponsored event. School-sponsored and schoolapproved cadet training events are conducted under the purview and
responsibility of the units/schools attending/participating and as
such, are subject to the sponsoring institution's rules, vice the Naval
Service Training Command (NSTC). Approval authority for all training
events during this particular LA is the school district operating with
permission of their duly appointed representatives, such as the
sponsoring school's principal or the school district's superintendent.
Formal Operational Risk Management (ORM) plans are required for all
NJROTC cadet training events. It is common for approved activities to
be recurring, on an annual basis for example, and therefore lend
themselves to an initial detailed ORM documentation with periodic
reviews, changes, and updates as situation may dictate. Cadet training
safety must not be compromised at any time. Instructors are tasked with
the responsibility of conducting risk assessments before, during, and
after training. Each instructor will review and become familiar with
the five steps of risk management. Risk assessment worksheets will be
completed and maintained for all cadet training events.
The five-step risk management process is:
(1) Identify hazards. Identify hazards inherent in the training and
hazards from other factors, such as the weather.
(2) Assess hazards. Determine the worst injury possible, and the
likelihood it would occur. The instructor, designated trainer or event
supervisor will conduct the assessment and maintain a record of the
assessment.
(3) Develop controls and risk decisions.
(4) Implement controls. Implement all measures possible to reduce risks
to the lowest level before training starts.
2
(5) Supervise. Ensure all control measures are in force during the
entire training event.
The following measures are available to ensure training safety:
(1) Formal ORM documentation
(2) Training Time Out (TTO) procedures
(3) Cadet physical examinations
(4) Risk factor screening questionnaires
(5) Increased situational awareness exhibited and practiced by all
attending SNSI/NSI’s.
(6) Common sense, sound-judgment, and mature adult reasoning
Regrettably, even under controlled conditions, accidents may happen.
Due to this reality, all units are required to develop and maintain
ready reference pre-mishap plans (PMP). A trip-specific PMP is required
whenever cadets leave their respective campus as part of any NJROTC
unit activity.
Characteristics of a thorough PMP include:
(1) drafted and put in place prior to commencement of arduous or
potentially high-risk activity
(2) Contain location(s)/telephone number(s) of first responders
required by the nature of the event
(3) Identifies location(s) of first aid assets (first aid kits, CPR
qualified members etc.)
(4) Identifies location of first response mechanical devises
(isolation devises, cut-off switches, fire extinguishers etc),
(5) Lists parties/offices and their respective phone numbers to be
notified in event of an incident
(6) Lists chain of command phone numbers (school and Navy) used in
making required incident or hazard reports per area-specific
guidance.
Generic PMP should be developed in advance and further tailored for
each unit evolution.
Additionally, if a cadet requires medical attention due to injury or
illness during a training event/activity, the SNSI/NSI must immediately
submit an NJROTC Safety Report to the Area Manager Office as soon as
practical and contact the Area Manager by phone/email to report
emergent situations until a documented safety report can be submitted.
All units and instructors following established procedures to safely
conduct NJROTC training are commended. All units shall routinely review
and ensure compliance to remain steadfast in our obligation to the
safety of cadets participating in the NJROTC program and at this
particular LA.
/s/
LTCOL W. IVORY, USMC, RET
SNSI, COCKE COUNTY TN NJROTC
AREA 9 EAST TN LA OFFICER IN CHARGE
3
ENCLOSURE (1)
Leadership Academy Information Sheet
1. General. Participation in the Cocke County High School sponsored Naval Junior
ROTC Leadership Academy at Clyde Austin 4-H Camp in Greeneville, TN is
available to both male and female cadets. Participating cadets should understand
that they will remain in a controlled atmosphere during their stay, although some
limited free time may be available. Cadets should be informed that the purpose of
the program is to prepare selected NJROTC students for leadership roles in their
respective units. All NJROTC cadets should be thoroughly counseled on the
physical and disciplinary demands of this accelerated training.
2. Cadets will be billeted at the Clyde Austin Camp Greeneville, TN. and will
subsist at the general mess. Cadets will be tested on their ability to compete in a
stringent physical and mental environment. Classes may consist of subjects on
physical fitness, practical leadership, advanced military drill, orienteering, service
etiquette; self-awareness and NJROTC subject areas which will familiarize the
cadets with the many duties in the administration of an NJROTC unit.
3. Selection of cadets is based on the following criteria:
a. Be a volunteer
b. Be a second or third year cadet expecting to return and complete the junior
and/or senior year in the unit, or be an exceptional first year student slated
for a leadership position in the unit for the coming fall.
c. Have no record of disciplinary problems in the unit or school. (verified by
the NSI)
d. Have a high school grade point average of 2.5 or higher on a 4.0 scale
(waived on case-by-case basis by the naval science instructor)
e. Be well-trained in the basics of military drill and be highly motivated.
f. Demonstrate to the NSI an aptitude for the NJROTC that will ensure
success in a military training environment.
g. Having completed a pre-participation sports examination, performed by a
certified medical provider, within 12 months of the date, AND DATED
AS SUCH, of participation in the Leadership Academy PFT.
h. Having completed the NJROTC Heath Risk Questionnaire, signed by the
participant and the participant’s parent/guardian (and completed and
signed by a licensed medical practitioner if necessary).No latter than 45
days prior to start of leadership academy.
i. Be in good health and physical condition as determined by regular
participation in high school physical activities. No cadet will be permitted
to attend the Leadership Academy who has asthma or a heart condition.
j. Have completed the NJROTC PRT within six weeks of coming to LA.
Cadets attending the Academy must be in good physical condition in order
to complete the early morning calisthenics, the 1.0-mile run, and the
orienteering test. All cadets shall be given the PRT. Cadets who fail to
successfully pass the PRT on the morning of the second full day of
training will have their SNSI/NSI NOTIFIED FOR
TRANSPORTATION HOME .NO REFUND WILL BE GRANTED.
4
4. Health Insurance and Physical Fitness. Individual arrangements should be made
at each high school prior to departure, for health and accident insurance to cover
the cadets during their training. Screen your cadets carefully and ensure that you
do not bring or send someone who may have a medical or physical problem,
which would prevent them from participating (no cadets accepted with
asthmatic or heart conditions). Ensure the medical and dental accident
insurance data on the Standard release form, enclosure (4), is complete. “GEICO’
or “BLUE Cross” is not enough! The company name plus policy/ID number
COPY of card FRONT and BACK along with a telephone
5.
6.
7.
8.
9.
confirmation number is required! It is most imperative that we have a copy of the
insurance card, (front and back) in the event the cadet has to be taken for medical
care at a civilian treatment center!
Grooming. Upon ARRIVAL at the LA site, male cadets will have NJROTC
regulation haircuts, and female cadets will not be wearing make-up. Proper
grooming standards will play a large part in the Academy training. SNSI/NSI’s
are NOT AUTHORIZED NOR ALLOWED to administer hair cuts to cadets
as part of the LA. Ensure proper grooming standards PRIOR to arrival.
Uniforms and Equipment. Enclosure (2) lists items of uniform and equipment
required by each cadet. Uniforms will be required for the entire period of training.
Rank/rate insignia and ribbons will NOT be worn. All cadets should bring two
small fowled anchors (normally worn on garrison cap) and two NJROTC collar
devices. (Rank/rate insignia and ribbons/medals may be worn ONLY for the
graduation exercise, otherwise, they are NOT allowed during any training
phase of LA.) There is no requirement for cadet to bring a dummy rifle.
Forms Submission shall be made per the promulgation letter.
Cost. $100 for each participant. Cadets should bring additional money for food
during travel to and from LA, but not for snacks and/or tobacco products. Junk
food and tobacco products such as smoking/chewing/dipping will not be
permitted at the NJROTC Leadership Academy.
Any cadet wishing to attend Leadership Academy for a second time as a
“graduate cadet aide” must be nominated by his/her naval science instructor. The
needs of the Academy will determine which nominees will be selected. It is
mandatory that the cadets who volunteer for this Academy position meet the
following criteria:
a. Be a graduate of the Leadership Academy, and possess a silver cord.
b. Hold an officer status in their NJROTC unit.
c. Be highly motivated to work with their instructors and peers in a safe,
positive, and mutually respectful manner.
d. Have a high school grade point average of 2.5 or higher on a 4.0 scale
(waived on a case-by-case basis by the naval science instructor).
e. Have an outstanding record for leadership ability within their NJROTC
unit.
f. Be in outstanding physical condition in order to participate in the daily PT
activities with the Academy cadets. This includes having a pre-
5
participation sports physical examination, performed by a certified
medical provider, within 12 months of the Leadership Academy.
g. Having completed the health risk factor questionnaire, signed by the
participant and the participant’s parent/guardian. (And completed and
signed by a licensed medical practitioner if necessary).
h. The PRT test will be conducted on the morning of the second full day of
training. For failures, the concerned SNSI/NSI WILL BE NOTIFIED FOR
TRANSPORTATION HOME. CADETS CANNOT STAY AT THE
ACADEMY.
The tuition fee for a graduated cadet aide will be $100.00 .
Graduate aides will be expected to wear their NJROTC uniforms whenever
appropriate, and shorts or athletic gear as required for their assignments. At no time
will the graduate aide wear clothing which does not reflect the leadership spirit of the
Academy, or set a poor physical appearance example.
Graduate aides are expected and required to set the example for all attending cadets.
Their behavior and actions will be that of treating others as they themselves would
expect and desire to be treated/respected. Graduate aide acts of ridicule,
embarrassment, and hazing are strictly forbidden.
Specific Aide duties, roles, and responsibilities, will be conveyed during a dedicated
graduate aide indoctrination session on day one of the LA.
10. Location and Directions.
a. Location. Clyde Austin 4-H Center, 214 4-H Lane, Greeneville, Tennessee.
b. Directions. See Enclosure (10).
6
ENCLOSURE (2)
Recommended and Required Equipment
And Personal Items for Cadets Attending Leadership Academy
1. Mandatory items of uniform (male) to be supplied by home unit:
a. Navy Service Uniform:
 3 kaki shirts
 3 Navy blue trousers
 2 black belts
 2 brass belt buckles
 1 Navy blue garrison cap
b. Other uniform parts and accessories:
 1 black leather shoes (issue type, no corfam)
 2 NJROTC collar devices
 2 small fouled anchor for garrison cap and shirt
 1 name tag
c. Compass
d. SWORD AND BELT THAT FITS CADET PROPERLY. SWORD SHOULD
BE ENGRAVED WITH UNITS NAME FOR EASY ID.
2. Mandatory items of uniform (female) to be supplied by home unit
a. Navy Service uniform
 3 khaki shirts
 3 Navy blue slacks
 2 black belts
 1 Navy blue garrison cap
 2 brass belt buckles
b. Other uniform parts and accessories
 1 black leather shoes (issue type – no corfam)
 2 NJROTC collar devices
 Two small anchors for garrison cap and shirt
 One nametag
c. Compass
d SWORD AND BELT THAT FITS CADET PROPERLY. SWORD SHOULD
BE ENGRAVED WITH UNITS NAME FOR EASY ID (Only for Leadership
Academy Cadets) Not Basic Leadership Academy Cadets.)
Note: All male and female items of uniform should fit well, be free of paint and
grease, and have the necessary NJROTC patch affixed in the proper position.
3. Mandatory and recommended items- NOT UNIFORM ISSUE – to be supplied by all
cadets- MALE AND FEMALE
a. Mandatory Items
One swimsuit (female=one piece only)
1 pair of gym shoes (white preferred)
(Leadership Academy)
2 P.T. Yellow NJROTC shirts-2 pairs of gym shorts Navy NJROTC Issue
7
(Basic Leadership Academy)
4 P.T. Yellow NJROTC/ 4 pairs of gym shorts Navy NJROTC Issue
4 pairs of black socks
4 pairs of white athletic socks
1 can of brasso metal polish
1 can of black shoe polish (no liquid) with shine rag
2 mechanical pencils with lead
1 twelve-inch ruler
4 white t-shirts for wear with uniform
1 sunscreen (preferably protection 15 or higher)
1 pair of shower shoes
3 bath towels
2 wash cloths
2 Single straight sheets
1 Pillow case
1 Blanket
1 Pillow
 necessary undergarments as required
 Necessary toilet and hygiene articles (toothbrush, toothpaste, soap, soap
dish, shampoo, shaving gear, underarm deodorant, etc.)
b. Recommended additional items:
Sports bras for females who need them
Cleaning and polishing rags
Scrub brush
Travel iron
Sewing kit
Laundry bag
7 hangers
4. Absolutes
a. females….wear no make-up
b. females…..wear no off-color hair pins, only hair colored bobby pins
c. all……bring no shoulder cords, rank/rate devices, or ribbons
d. all……wear no medals
e. all…….take no radios, stereos, TV’s, cell phone, electronic games, ect
f. no tobacco, drugs other than prescribed, drug paraphernalia, or alcoholic
beverages
g. No clothing promoting alcohol, drugs, gang affiliation, or that is sexually
suggestive.
8
ENCLOSURE (3)
Leadership Academy Registration Payment Form
Complete this form and mail with payment (school check or money order MADE
PAYABLE TO Cocke County NJROTC) to:
Cocke County NJROTC Unit
216 Hedrick Drive
Newport, Tn 37821
Unit: ______________________________________________
NAME
SIZE
S,M,L,XL
PAYMENT
Instructor(s) who will attend: _______________________________
Female chaperone:
Cadets to attend:
Cadet Aide
____
___________________________________
____
____________________________
____
Male name- T-shirt size
Female name- T-shirt size
_______________________
_______________________
_______________________
________________________
_______________________
________________________
_______________________
________________________
_______________________
________________________
_____________________________ M/F
Total $_________
9
________________________
ENCLOSURE (4)
NAVAL JUNIOR RESERVE OFFICERS TRAINING CORPS
(NJROTC)
STANDARD RELEASE/MEDICAL EMERGENCY FORM
Date:
_____________________
I, _______________________________________, being the legal parent/guardian of
__________________________________________, a member of the Naval Junior
Reserve Officers Training Corps, in consideration of the continuance of his/her
membership in NJROTC and/or his/her acceptance for NJROTC training, do
hereby release from any and all claims, demands, actions, or causes of action, due to
death, injury, or illness, the government of the United States and all its officers,
representatives, and agents acting officially or otherwise and also the local, regional,
and national Navy officials of the Unites States, and the U.S. Naval Reserve Officers
training Corps and its officers and officials.
I hereby authorize personnel of the Department of Defense, Armed Forces, Public
Health Service, or civilian physicians to render such medical and dental care as may
be necessary and medically indicated in the case of my son/daughter during his/her
period of training, as is deemed necessary by a qualified practitioner.
I understand that care at a military medical facility for non-military dependents will
normally be rendered on a temporary (emergency) basis only; if further care is
indicated, the patient will be transferred to non-military care as soon as possible.
Emergency care provided to cadets who are not military dependents at a military
medical facility may be subject to reimbursement, and I may be billed for the care
provided. For Navy and Marine Corps sponsored activities, such care is authorized
by NAVMEDCOMINST 6320.3B.
My son/daughter/ward has been determined to have the following allergies:
_____________________________________________________________________
He/she requires medication for the treatment of:
______________________________________________________________________
below are listed any other medical conditions which my son/daughter/ward is
known to have, which would preclude or limit in any way his/her participation in
physical exercise and athletic programs.
His/Her physician is:
Name: _____________________________________
Address: ____________________________________
Telephone: (include area code) ___________________
10
Medical/Injury Co. Insurance Info*
Dental Insurance Info*:
_________________________
(Name)
_______________________________
(Name)
__________________________
(Street)
(Street)
___________________________
(City, state, zip code)
_________________________________
(City, state, zip code)
____________________________
(Policy/ID Number)
_________________________________
(Policy/ID Number)
____________________________
(Telephone Confirmation #)
_______________________________
__________________________________
(Telephone Confirmation #)
COPY OF INSURANCE CARD FRONT AND BACK
*This insurance is not required. However, the information provided may be
required to obtain non-emergency care.
PRIVACY ACT NOTIFICATION
Under the authority of 5 U.S.C. Sec. 301, the information regarding your
child’s/ward’s health, medical condition and treatment is requested, in order to
verify any need to administer medication and to enable medical/dental personnel to
diagnose and treat any emergency condition which may arise during training.
Pursuant to the Privacy Act, 5 U.S.C. Sec 552, the requested information will not be
divulged without your written authorization to anyone other than NJROTC area
personnel involved with administration of NJROTC activities, and medical/dental
personnel requiring the information in order to effectively treat any health problem
which may arise. Disclosure is voluntary; however, failure to provide the requested
information will preclude your child’s/ward’s participation in the training.
(Signature of parent/guardian)
(Address)
(City)
(State)
(Telephone: home)
(Zip)
(Work)
11
ENCLOSURE (5)
NJROTC HEALTH RISK SCREENING QUESTIONNAIRE
Cadet
Name:________________________________________________________________
(Printed Name)
NJROTC Unit:_____________________________________________________
High School
Date of your most recent pre-participation sports physical
examination___________________
Part A – TO BE COMPLETED BY THE CADET AND PARENT/GUARDIAN
Directions: Please answer Yes or No to the following questions: (Do not leave any
questions blank)
1. Do you have difficulty doing strenuous (great effort) exercise? ___________
2. Have you been told NOT to participate in long distance runs, such as a 1.5-mile-run?
____________
3. Have you been told NOT to do curl-ups or push-ups by a physician or other medical
professional? __________
4. Do you exercise less than three times per week for at least thirty minutes?
_____________
5. Have you had any broken bones or a serious accident in the last three months?
_______________
6. Do you use tobacco of any kind? _______________
7. Have you experienced chest, neck, and jaw or arm discomfort while doing physical
activity? _________________
8. Do you have asthma or are you using an inhaler to aid in breathing?_______________
9. In the last month have you felt any chest pain at rest? ________________
10. Do you have any known cardiac (heart) disease? _________________
11. Do you think you are overweight? _________________
12. Do you have dizzy/fainting spells, frequent headaches, or frequent back pains?
________________
13. Have you ever experienced dehydration after strenuous physical exercise?
____________________
14. Are you currently under treatment by a physician or other medical practitioner?
____________________
15. Has your mother or sister died without any explanation or suffered a heart attack
before the age of 55? _______
16. Has your father or brother died without any explanation or suffered a heart attack
before the age of 45? ______
17. Do you have high blood pressure or are you on blood pressure medication?
____________
18. Has a doctor ever told you that you have high cholesterol or are you on cholesterol
medication? __________
19. Do you have sugar diabetes? ______________
12
20. Have you experienced episodes of rapid beating or fluttering of the heart?
________________
21. Do you suffer from lower leg swelling of both legs? _____________________
22. Do you have difficulty breathing or have sudden breathing problems at night?
__________________
23. Do you have any personal history of metabolic disease (thyroid, renal, liver)?
__________________
24. Do you have a bone, joint, or muscle problem that prevents you from doing
strenuous exercises? _______
25. Have you unintentionally lost/gained more than 10 percent of your body weight since
your last PFT? _______
26. Have you ever been diagnosed with Sickle Cell Trait?___________
________________________________________________________________________
Cadet Signature
Date
Parent/Guardian Signature
Date
Part B - If any of the answers to the questions above were YES, request that the
following section be completed and signed by a licensed medical doctor or registered
school nurse:
Significant clinical history and/or current medication and treatment regimen of the above
cadet: (Use reverse side if necessary)
Recommended/released for participation in strenuous physical activities including
the 1 mile-run?
YES
NO
__________________________________________________________________________
Signature of Medical Practitioner
Date
CNET Form 1533/106 (09-02)
13
ENCLOSURE (6)
Date:
From:
To:
Subj:
ACADEMY CADET STATEMENT OF AGREEMENT
____________
Cadet ___________________________NJROTC Unit
_______________________________ HS
OIC Leadership Academy
Via: Naval Science Instructor, _____________________________ HS
CADET AGREEMENT FOR ATTENDANCE AT THE NJROTC
LEADERSHIP ACADEMY /BASIC LEADERSHIP TRAINING
Ref: (a) NJROTC Leadership Academy/BASIC LEADERSHIP TRAINING LOI
1. In accordance with the requirements stipulated in reference (a), I agree that I will
observe or fulfill each of the following stipulations in conjunction with my
attendance at the Area NINE Leadership Academy:
a. Provide to the OIC via your SNSI the following required forms:
 Standard Release Form/Cadet Record Form
 Cadet Statement of Agreement
 NJROTC Health Risk Questionnaire

Copy of current (dtd after JULY 2011) Pre-sports Physical Examination
b. Upon arrival at the Academy, have in my possession all required articles of
uniforms and equipment.
c. Report to the Academy with a regulation haircut. (Males)
d. Report to the Academy without wearing make-up and not use any form of
cosmetics during the training cycle. (Females).
e. Report to the Academy properly hydrated and in good physical condition, and be
able to pass the PFT requirements on the second full day of training.
2. I understand that not meeting any of the listed requirements may result in my
early dismissal from the Academy and a failure to graduate, and the possibility of
personal expense for transportation home.
3. As a Leadership Academy participant, I will provide a tuition fee of $100.00 for
the event.
____________________________________
Parent/Guardian signature
Date __________________________
14
_________________________________
Cadet Signature
First Endorsement:
From:
Naval Science Instructor _________________________________ HS
1. Forwarded.
2. I certify that all the basic requirements for attendance at the Leadership
Academy have been briefed to the above cadet and he/she has passed the NJROTC
PFT within the last testing period. His/Her 1.0 mile run time was _____________.
NSI Signature.
15
ENCLOSURE (7)
LEADERSHIP ACADEMY GRADUATE CADET AIDE AGREEMENT
Date:
From:
To:
Subj:
__________________
Cadet ___________________________NJROTC Unit ________________________
HS
OIC Leadership Academy
Via: Naval Science Instructor, _____________________________ HS
AGREEMENT FOR A POSITION AS A GRADUATE CADET AIDE AT THE
NJROTC LEADERSHIP ACADEMY FOR AREA NINE
Ref: (a) NJROTC Leadership Academy LOI
1. In accordance with the requirements stipulated in reference (a), I agree that I will
observe or fulfill each of the following stipulations in conjunction with my selection as a
graduate cadet aide at the Leadership Academy:
a. Be a graduate of the NJROTC Leadership Academy, with a silver cord.
b. Presently hold or selected to hold officer status in my NJROTC unit.
c. Have a high school grade point average of 2.5 or higher on a 4.0 scale (waiver able on a
case-by-case basis by the NSI).
d. Have an outstanding record of leadership ability within my unit.
e. Be properly hydrated and in outstanding physical condition in order to participate in the
daily PT activities with the Academy cadets. This includes submitting the NJROTC Health
Risk Screening Questionnaire to the Academy officer-in-charge upon arrival at the
Leadership Academy.
f. Be highly motivated to work with my peers.
2. I understand that not meeting any of the listed requirements may result in my early
dismissal from the Academy, failure to receive Cadre Pin, and the possibility of personal
expense for transportation home.
3. As a Leadership Academy participant, I will provide a tuition fee of $100.00 for one
week.
____________________________________
Parent/Guardian signature
_________________________________
Cadet Signature
Date __________________________
First Endorsement:
From:
To:
Naval Science Instructor _________________________________ HS
OIC Leadership Academy
1. Forwarded.
NSI signature.
16
ENCLOSURE (8)
Arrival, Check-in and Departure Procedures
1. Check in NLT 1200 5 July 2012 Dining facility will be open to serve evening meal
at 1800 5 July 2012 .
a. We will have the graduation at 10:00 am SUNDAY 8 JULY 2012 Departure
will be to follow shortly thereafter.
b. P.F.T. TEST WILL BE CONDUCTED ON THE MORNING OF THE
SECOND DAY OF TRAINING 6 JULY 2012. FAILURES WILL BE
SENT HOME.
17
AREA 9 EAST LEADERSHIP ACADEMY MEDICAL FORM
_________________________________________
PRINTED CADET NAME
I______________________________________ GIVE THE ASSIGNED TVLSA
PRINTED PARENT NAME
MEDIC AUTHORIZATION TO ADMINISTER MEDICATIONS BROUGHT TO AREA 9
EAST LEADERSHIP ACADEMY BY MY SON/DAUGHTER AND OVER THE COUNTER
MEDICATIONS FOR MINOR AILMENTS HEAD ACHE, SORE THROAT, STOMACH
ACHE ECT…
IN THE EVENT OF AN ACCIDENT I AUTHORIZE AREA 9 EAST LEADERSHIP
ACADEMY MEDIC TO PREFORM FIRST AID ,CPR ,BASIC MEDICAL NEEDS UNTIL
ADVANCED MEDICAL TREATMENT AT A CIVILIAN MEDICAL CENTER CAN BE
OBTAINED.
_______________________________
PARENT SIGNATURE
SEAL
_______________________________
NOTORY SIGNATURE
ENCLOSURE (9)
18
Enclosure (10)
Clyde Austin Camp Greeneville, TN– Close-up Map
N
Directions: Follow Highway 11E East from I-40 or West from Johnson City to Greeneville. At US 70 intersection in Greeneville, turn South on
US 70. From the Hwy 321 & Hwy 70 intersection travel south on US 70 for 4.9 miles to East Allens Bridge Road. Look for UT sign on right
side of road.
Turn left onto East Allens Bridge Road. Veer left onto Whirlwind Road. After approximately 1 mile, turn
left onto 4-H lane.
19
Follow signs for UT Clyde Austin 4-H Center.
Enclosure (10)
UT
Sign
20