These questions are designed to determine and ensure the opportunities for success at NMMI.

Positive responses will not automatically prevent

admission but are intended to provide NMMI additional information that may be helpful in dealing with issues or problems that may impact the
cadet’s success in both the Corps and the classroom. Please use additional sheets as necessary to provide complete explanations.

Cadet Name: ____________________________ ID #:____________________________Expected Grade Level:_________________

1. Have you ever been suspended or expelled from school? Explain:

2. Have you ever been in counseling? Family

List Outcomes Mental Health

Substance Abuse
3. Are you presently under doctors care or taking If yes, explain:
prescribed medications?

4. Are you now or have you ever taken any regularly ADHD
prescribed medications for any of the following:
Depression
List Medication and Dosage for all that apply
Anxiety
List time frame medication was used and stoppage date, if
applicable Anger

List doctor or clinic prescribing medication Sleep

Other – list:

5. Excluding minor traffic violations, have you ever Explain:

been arrested?

If yes, were you placed on probation?

If yes, when will the probation be completed?

6. Do you use alcohol or tobacco products? Or have you ever Explain:

used them?

7. Marijuana is not tolorated at NMMI. Will this be a

challenge for you?
8. What organizations do you belong to? Church

Describe your involvement with them and any awards that Scouting
you have received.
School

Athletics

Academic

Other

9. Describe any/all leadership positions that you have held in

the above mentioned organizations, or any other activity.
You may use this page for additional comments if necessary
10. What classes are you taking this year? Are you taking any
honors or other forms of advanced placement courses?

11. What is the longest time period that you have been away Explain:
from your home without your parents or family members?
Where were you?

12. What do you consider to be your best subjects in school?

Why?

13. What do you consider to be your most difficult subject in

school? Why?

14. Have you ever gone for tutoring for any subject? If yes, which subject(s)?

15. Do you keep your room orderly when living at home?

16. Do you usually get along well with your peers?

17. Do you exercise regularly?

18. Have you had a major illness or surgery within the past Explain:
two years?

19. Have you had a death in your family or the death of a close Explain:
friend in the past year?

20. How many different schools have you attended in the last
two years?

21. Do you enjoy being a leader? Give an example of your leadership experience:

22. Do you prefer working as a member of a team or do you Give an example:

prefer to work alone on projects?

23. How much time do you spend playing computer games or

surfing the net?

24. What do you think will be the hardest part of being a

cadet?

25. What do you think will be the easiest part of being a cadet?

26. Do you have trouble starting projects and not finishing

them?

27. What is your goal in life?

I affirm the information provided above is true and correct.

Cadet Name: ____________________________ ID #:____________________________Expected Grade Level:_________________

Signature of Prospective Cadet:_____________________________________________________________________ Date____________________________________

08/2017