Fort Lauderdale
Sea Cadets

Request Information
Information Request Form

Information is usually answered within 48 hours, Thank you for your request.

Adult's First Name
Adult's Last Name
Address Street 1:
Address Street 2:
City:
Zip Code: (5 digits)
State:
Daytime Phone:
Evening Phone:
Cell Phone:

Email:
Potential Cadet #1 - First Name:
Potential Cadet #1 - Last Name:
Potential Cadet #1 - Date of Birth:

Male or Female:
Potential Cadet #2 - First Name:
Potential Cadet #2 - Last Name:
Potential Cadet #2 - Date of Birth:

Male or Female:

What would you like to receive information about?

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Please give us any other information you'd like that may help us respond better to your request: