APPLICATION FOR SCHOOL DISTRICT
PARTICIPATION IN THE
Troops-to-Teachers JOB REFERRAL PROGRAM
DISTRICT INFORMATION Please print carefully, or type

Name of School District:

Address:


City and State:
Zip Code:

PRIMARY USER

Name:

Title/Position:
Telephone:                                                               FAX:
E-Mail:

PRIVACY ACT STATEMENT

I understand the information to be accessed via the Internet is Privacy Act Information. I agree to treat this information IAW AUTHORITY: 5 U.S.C. 301, E.O. 9397 and will safeguard the assigned password and user name to prevent unauthorized disclosure.

REQUESTER

Signature:                                                           Date:

Title/Position:

Submit this application to:

DEFENSE ACTIVITY FOR NON-TRADITIONAL SUPPORT (DANTES)
Troops-to-Teachers
6490 Saufley Field Road
Pensacola, FL 32509-5243

Or FAX to: (850)452-1096