Halifax Shore Messes - Out Clearance

Please complete this form if you are clearing out of a SHORE Mess

CF One Number

Service Number

* required

First Name

*required

Last Name

* required

Date of Birth

Mess

*required

Rank

Member Status

New Residential Address

City

Province

Postal Code

Phone Number

E-mail

*required

Reason for Out Clearance

Losing Unit

Gaining Unit

Change of Strength Date (COS) Discharge Date

* required

Any Additional Information

Privacy Notice

I confirm that I have read the PRIVACY NOTICE.

Consent agreement

By registering to this program or activity, I consent to the collection and use of my personal information as described in the privacy notice above.