Lighthouse Tour, US Citizen clearance info

Lighthouse Tour, US citizen/resident clearance info

Information is encrypted to database for secure collection
Date of Tour*

MonthDayYear
MM-DD-YYYY
First Name*
Middle Initial*
Type "9" if no middle initial
Last Name*
Birth Date*

MonthDayYear
MM-DD-YYYY
Resident Status*

Minor, under 18US Citizen or Permanent Resident
Birthdate Check,
MINOR under age 18, Adult requires resident status checked.
Drivers License# *
Issuing State*
Social Security Number*
Would you like a email receipt of submission? (no secure data is transmitted)

NoYes
Email*
example@example.com
Should be Empty:

Lighthouse Tour, US citizen/resident clearance info