Name:CompanyFrom: To: (Time) (Time) (i.e.; 1500)(i.e.; 2130)From:To: (Date) (Date)(i.e.; dd/mm/yyyy)(i.e.; dd/mm/yyyy)Address while on leave/pass:(Street)(City)(State)(Zip)In case of emergency, I can be contacted at:(Cellular/Mobile phone number)Reason for Request:MilestonesTask specificationsInitials1. I am not scheduled for guard detail OR Honor Guard during this time2. I am not restricted to campus due to a disciplinary action3. I am not restricted to campus due to academics or overdue fees Cadet Leadership ApprovalLeaders NamePositionInitials1. 1SG2. PLT SGT3. SQD LDRCompany TAC Officer (All Cadets) AND Barracks TAC Officer (Female Cadets) APPROVED __________InitialsDISAPPROVED __________ InitialsFOR USE OF THE ACADEMIC DEANS OFFICE (If classes will be missed)APPROVED __________ InitialsDISAPPROVED __________ InitialsFOR USE OF THE COMMANDANT’S OFFICE ONLY APPROVED __________ InitialsDISAPPROVED __________ Initials TIME OUT ____________________TIME IN ____________________Updated: February 2010Marion Military InstituteMarion, AlabamaOffice of the CommandantCadet Request for Leave or Pass Date of Request: _/9j/4AAQSkZJRgABAQEAYABgAAD/2wBDAAoHBwgHBgoICAgLCgoLDhgQDg0NDh0VFhEYIx8lJCIf
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