Transcription of CONTINUED ON BACK - Rhode Island
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CONTINUED ON BACK - Rhode Island
TRANSACTION TYPE (SELECT ONE)LICENSE(complete sections A, B, C, D, E*, F*G)A. APPLICANT S INFORMATION (COMPLETE ALL FIELDS)TELEPHONE:SUFFIX:RI DRIVER S LICENSE # / ID # / PERMIT #:DATE OF BIRTH: (MM/DD/YY)GENDER:SOCIAL SECURITY NUMBER:HEIGHT: : COLOR:COUNTRY:STATE/PROVINCE:CITY:CONTIN UED ON BACKC. PHYSICAL INFORMATION (COMPLETE ALL FIELDS)D. GENERAL QUESTIONS (COMPLETE ALL FIELDS)NEWPASSPORT / EMPLOYMENT AUTHORIZATION / RESIDENT ALIEN card #:MALEFEMALEDo you want to register as an organ and tissue donor?ACTIVE MILITARY:100% DISABLED VETERAN:YESNOB. PLACE OF BIRTH (COMPLETE ALL FIELDS)Pursuant to RI Gen. Laws 31-10-47(a), (a)ny male, United States citizen or immigrant who is at least eighteen (18) years of age, but lessthan twenty-six (26) years of age shall be registered in compliance with the requirements of section 3 of the "Military Selective Service Act",50 App.
50 U.S.C. App. 451 et seq., when applying to receive a driver's license, renewal or identification card or renewal.” Pursuant to RI Gen. Laws 31-10-47(b), the applicant recognizes that by submitting this application he is consenting to registration with the Selective Service system,
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