Temporary Military Deployment Guardianship Form
Service Member Information
Name
Rank
Branch
Unit
Contact Information
Deployment Location
Deployment Dates
Child(ren) Information
Name(s)
Date(s) of Birth
Temporary Guardian Information
Name
Relationship to Child(ren)
Address
Phone Number
Email
Responsibilities and Authorization
Please specify any specific responsibilities or limitations for the temporary guardian (if any):
Additional Information
Medical Information, Insurance Details, or Other Notes:
Service Member Signature
Date
Temporary Guardian Signature
Date