Please complete this form as thoroughly as possible It is important that you fully understand that our program is for young people ages 13-18 who are motivated to attend. We are NOT a delinquency program.

If you are ready to save a spot for this summer please visit xmccamp.com and click Enroll Now!.

Personal and Contact Information

Applicant's Full Name: *

Phone: *

Email: *

City and State or Country: *

Gender *

Age on July 1st, 2015: *

Next of Kin's Full Name: *

Relationship *

Phone: *

Email: *

Conduct and Educational Information

Education Level: *

Have you ever been arrested, or expelled from school? * 🛈

Please explain

Cadet Program Experience

Most Recent Cadet Program Experience: *

Cadet Rank:

Have You Completed Ten or More Days of Residential Basic Training?

If "Yes," When and Where?

Information Request, questions.

Additional Information or Questions

Would you like to be contacted by phone or e-mail about our programs this summer?

Preferred Method: *

Best Time to Call

Working Hours (9am-5pm EST)

Evening (5pm-9pm EST)

Program Interested in: *

Referral Source: *