General Leave Form

Please complete the following form to request your cadet's furlough for requests for college visit or for doctor, dental or eye care appointments. With questions, please contact Deputy Commandant of Transportation and Security Jeff Howard at jeff.howard@missourimilitaryacademy.com or at 573.581.1776 ext. 436.

Basic Information

Cadet First Namerequired

Cadet Last Namerequired

Graderequired

Agerequired

Companyrequired

What is your furlough reason?*

College Visit Medical Appointment Other

What is the name of the college?required

Please state reason:required

Please provide any relevant details about this leave.

Appointment Details

Leave Daterequired (mm/dd/yyyy)

Leave Timerequired

Return Daterequired (mm/dd/yyyy)

Return Timerequired

What is the name of the institution he will be going to?

What is the address of the institution he will travel to?

What is this institution's contact phone number?

Travel Plans

How will your cadet travel?*

I will pick up my cadet. My cadet will be picked up by another cadet's family. My cadet needs MMA local chaperoned transportation. My cadet needs MMA chaperoned transportation to the St. Louis, Columbia or Mexico airport. My cadet needs MMA chaperoned transportation to/from MoExpress Shuttle Service in Kingdom City.

Please note:

Cadet's who are picked up by another cadet's family must have written approval from both you (their guardian) and the other cadet's family.
Cadet's using chaperoned transportation will be charged between $30-140 depending on the airport they are traveling to. See cost details below.

Please provide the first and last name of the person picking up your cadet.

First Name

Last Name

If your cadet is traveling with another cadet, please provide that cadet's first and last name.

Please indicate if your cadet will need transportation one way or both ways.

To the airport only at the beginning of furlough. From the airport only at the end of furlough. Both to and from the airport at the beginning and end of furlough.

The cost is the same, whether he uses MMA transportation one or both ways. Please indicate how you would like to be charged for this service.

Please note: Airlines may require you to pay a special charge for an unaccompanied juvenile. To avoid delays, please provide MMA with a copy of your paid receipt for this service. An extra charge of $100 will be charged to your QM account.

Transportation charged to my monthly bill Paid on MMA Pay Fees Portal

Please note that there is a $60 transportation fee to/from campus and Kingdom City.

What date is your cadet's MoExpress Shuttle scheduled for? (mm/dd/yyyy)

What time is your cadet's MoExpress Shuttle scheduled to depart from Kingdom City?

What time is your cadet's MoExpress Shuttle scheduled to arrive at his destination?

What is his MoExpress shuttle trip number?

Does your cadet have a returning shuttle?

Yes No, he will be dropped off.

What date is your cadet's MoExpress Shuttle scheduled for his return? (mm/dd/yyyy)

What time is your cadet's MoExpress Shuttle scheduled to depart from his destination to return to Kingdom City?

What time is your cadet's MoExpress Shuttle scheduled to arrive in Kingdom City for his return to campus?

What is his MoExpress shuttle trip number for his return?

Beginning of Furlough Flight Information

What airport will your cadet travel through?

St. Louis Lambert Airport - $140 Columbia Regional Airport - $80 Mexico Airport (private planes) - $30

Departure Date (mm/dd/yyyy)

Departure Time

Airline

Flight Number

What airport will he travel to?

Does he have any layovers? If so, where?

End of Furlough Flight Information

What airport will your cadet travel through?

St. Louis Lambert Airport- $140 Columbia Regional Airport - $80 Mexico Airport (private planes) - $30

Arrival Date (mm/dd/yyyy)

Arrival Time

Airline

Flight Number

What airport will he travel from?

Does he have any layovers? If so, where?

Comments or Questions

Electronic Signaturerequired

By typing your name, you consent that all the information given above is accurate to the best of your knowledge. You consent to allow MMA to follow these instructions with the understanding that proper permission has been granted.

Phone Numberrequired

Please provide the best phone number to reach you at with questions or clarification about this travel form.

Please send a confirmation email to the address below:

Please provide an email address where we can send a link to your current form.

Email Address :