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CDT 138

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FICHE DE RENSEIGNEMENTS - MUTATION DE LA RÉSERVE SUPPLÉMENTAIRE

CORPS DE CADETS/ESCADRON : _____________________________________________________

NOM : _____________________________________________________________________________

PRÉNOMS : ________________________________________________________________________
(VEUILLEZ INSCRIRE TOUS VOS PRÉNOMS ET SOULIGNER L'USUEL)

NAS : _____________________________________________________________________________

DATE ET LIEU DE NAISSANCE : ______________________________________________________

SITUATION MATRIMONIALE : _______________________________________________________

SCOLARITÉ : ______________________ RELIGION : ___________________________

LANGUE MATERNELLE : __________ SEXE : _______________________________

LANGUE SECONDE : ______________________________________________________ ________

OCCUPATION CIVILE : _____________________________________________________________

SERVICE ANTÉRIEUR

SERVICE (S) MATRICULE (S) DATES

ADRESSE ________________________________________
________________________________________
________________________________________
________________________________________
TÉLÉPHONE DOMICILE (_____)_____________________
TRAVAIL (_____)_____________________

CDT 138

(English on reverse)
INFORMATION SHEET TRANSFER FORM THE SUPPLEMENTARY RESERVE

CADET CORPS/SQN: __________________________________________________________________

SURNAME: __________________________________________________________________________

GIVEN NAMES: ______________________________________________________________________


(INCLUDE ALL YOUR GIVEN NAMES AND UNDERLINE THE ONE COMMONLY USED)

SIN:

DATE AND PLACE OF BIRTH: __________________________________________________________

MARITAL STATUS: ____________________________________________________________________

EDUCATION: ____________________________ RELIGION: ______________________________

PRIMARY LANGUAGE: __________________ SEX: ____________________________________

SECOND LANGUAGE:

CIVILIAN OCCUPATION:

PREVIOUS SERVICE

SERVICE (S) SERVICE NUMBER (S) DATES

ADDRESS ________________________________________
________________________________________
________________________________________
________________________________________
TELEPHONE RESIDENCE (_____)_____________________
WORK (_____)_____________________

CDT 138

(Français au verso)

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