New Member Enrollment and Support

Size: px
Start display at page:

Download "New Member Enrollment and Support"

Transcription

1 New Member Enrollment and Support

2 Only the (newest) ANCS 7001 (5-15) must be used. Complete pages 1-5. Two application are sent to DIRAUX. All signatures must be in blue ink. Enrollment forms are to be filled in blue ink. Coast Guard Auxiliary Association, Inc. Consent to Membership Form posted in the HR Corner SECTIONS I, II AND III - COMPLETED BY APPLICANT

3 SECTION IV Re-enrollments If applicable, the old member number should be entered. First page of application submitted if re-enrollment is less than 90 days. New Member Examination - Enter date and score. Read Privacy Act Statement read and completely understood by applicant. Boating Safety Course Certificate - check yes or no. Certificates of NASBLA approved courses listed in Chapter 8-6 of Auxiliary Manual are acceptable. Fingerprint Cards - Two cards signed in black ink. Proof of Citizenship US Birth Certificate or Passport if naturalized citizen, submit copy of certificate DD-214 if applicable

4 SECTION V APPLIANT INTERVIEW RECORD To be completed by the interviewer. This section is used as a check-off sheet to make certain the applicant has been informed of the membership opportunities and obligations in the USCG Auxiliary. SECTION VI PARENT/GUARDIAN SIGNATUE Completed by applicant s parent or guardian. Applicants 17 years of age must have at least one parent or guardian complete this section. Parent or guardian dates and signs in blue ink.

5 SECTION VII - APPLIANT STATEMENT AND SIGNATUE If applicant answers yes to Question 2, indicate branch of service. Per SECCEN, any enrollment application, where the enrollee indicates prior military service, said application MUST have a DD-214 or the National Guard equivalent NGB-22, for each branch of service indicated. A letter stating the DD-214 was misplaced or lost will not suffice. If an applicant does not have a copy of their DD-214 or NGB-22, they must obtain a copy prior to enrollment. This procedure is the same if someone desires to re-enlist or transfer within the branches of the military. It is the enrollee s responsibility to obtain all required documents PRIOR to submitting their enrollment application

6 SECTION VII APPLICANT STATEMENT AND SIGNATURE A copy of the DD-214 can be obtained from the following sources: If applicant answers yes to Questions 3-6, a statement of specifics should be submitted with the New Member Application to include date, city and state of offense, disposition and any comments including mitigating circumstances, along with a copy of any court documents Applicant may submit his statement in a sealed envelope for the DDSL s eyes only. IF SECCEN NEEDS ADDITIONAL INFORMATION, THE APPLICANT WILL BE CONTACTED. After reading the pledge, applicant dates and signs in blue ink.

7 SECTION IV AUXILIARY/SECCEN VERIFICATION OF U.S. CITIZENSHIP Section A - completed by applicant. Section B completed by an Auxiliary Fingerprint Technician, Auxiliary Citizenship Verifier or by a Law Enforcement Officer who has viewed the original document that is provided as proof of citizenship. Photocopy both sides of a passport ID Card. SECTION X PRIOR/CURRENT CLEARANCES Only applicable if a security clearance has been issued to the applicant by a federal agency within the past ten years. An additional document should be provided. Yes must be checked to print Pages 6 thru 9.

8 SPECIAL AGREEMENT CHECK (SAC) 86C All applicants - complete Sections 1 thru 6. American Citizens - complete Sections 13a & 13b. Naturalized Citizens - complete Sections 13a, 13b & 13c. Dual Citizens - complete 13a, 13b, 13c & 13d. If not applicable, place an entry N/A in each field. If applicant only has initials, enter initial in appropriate box and show (IO). If applicant has no middle name, enter NMN. If other names have been used, fill in the name and date. Box 5 - if you are a female and/or have been married, include maiden name and other married names if married more than once. Provide beginning and ending dates for each name. Identify maiden name with NEE.

9 AUTHORIZATION FOR RELEASE OF INFORMATION 85(E) All Applicants complete entering full name or aka names. PRIOR/CURRENT INVESTIGATION INFORMATION COVER SHEET The investigation must have been within the past ten (10) years. SF-86C (Pages 8 & 9) must be completed, signed, dated and attached to the cover sheet. STANDARD FORM 86 CERTIFICATION (SF 86C) To be completed by applicant additional blanks sheets of paper must contain applicant s name and SSN at the top of each page.

10 COMPLETED NEW MEMBER ENROLLMENT PACKAGES MUST CONTAIN: Two completed ANSC 7001 (5-15) Forms Completed Pages 1-5 or 1-9 (Security Issues) two complete sets. Enrollment form should be filled out in blank ink all signatures must be in blue ink. Completed, scored New Member Exam Answer Sheet (ANSC 7010). Two copies of document used for proof of citizenship If applicable, two copies of DD-214 Two fingerprint cards signed in black ink only. Copy of Boating Safety Course Certificate CGAUXA, INC Consent Form, March 14, 2014, Coast Guard Auxiliary Association, Inc. Consent to Membership. Photo of applicant either as paper photo or digital on CD. Photo must have red background and applicant should be wearing a light blue shirt. Include the name of applicant and flotilla number on the photo or CD.

11 COMPLETED NEW MEMBER ENROLLMENT PACKAGES MUST CONTAIN: A floppy disc will not be accepted. Use of staples or loose-leaf holes on an application is not acceptable. Applications should be printed on one side only. Two-sided copies are not acceptable. All new member packages must be submitted to the FC for final signature and forwarded to the DDSL/ADDSL within the Division via hand delivery or certified mail. Once the member package is sent to the FC, the HR Department is no longer responsible for the processing. The process is now the responsibility of the Security Department. After a month if the member is still listed in AP Status and the FC did not receive the New Member Welcome Aboard Package and Certificate, an entry should be placed in the D7 Help Desk at using New Enrollment Category.

12 Questions - Comments Human Resources Department

New Member Enrollment and Support

New Member Enrollment and Support New Member Enrollment and Support 3-1-14 Two (newest) Enrollment Applications (presently ANCS 7001 10-12). Two Fingerprint Cards. One New Member Course Examination answer sheet. (Form ANSC 7010) Coast

More information

U.S. Coast Guard Auxiliary Enrollment Application Procedure ANSC

U.S. Coast Guard Auxiliary Enrollment Application Procedure ANSC U.S. Coast Guard Auxiliary Enrollment Application Procedure ANSC 7001 7-1-17 PLEASE MUTE YOURSELF IF YOU WISH TO SPEAK, SEND ME A CHAT TO BE RECOGNIZED. THIS WILL ELIMINATE EVERYONE SPEAKING AT ONCE. THANK

More information

FREQUENTLY ASKED QUESTIONS (FAQS) Personnel Security Investigations (PSI)

FREQUENTLY ASKED QUESTIONS (FAQS) Personnel Security Investigations (PSI) FAQ & Answers approved by CG-86, SECCEN, G-OCX, & Aux Leadership (NACO) FREQUENTLY ASKED QUESTIONS (FAQS) Personnel Security Investigations (PSI) (also see page w/ definitions) (last updated 3/26/09) QUESTION

More information

Alabaster Legacy Scholarships Emerging Leader Network Scholarship

Alabaster Legacy Scholarships Emerging Leader Network Scholarship Alabaster Legacy Scholarships Scholarship Deadline May 1, 2017 Alabaster Legacy Scholarships The intent of this award is to encourage young women who are in pursuit of an education in preparation for vocational

More information

Alabaster Legacy Scholarships Bible College Scholarship

Alabaster Legacy Scholarships Bible College Scholarship Scholarship Deadline May 1, 2018 Women in Leadership The intent of this award is to empower women by providing funds for continued ministerial education. The goal of Women in Leadership is to enhance the

More information

2018 SCHOLARSHIP APPLICATION Military Spouse

2018 SCHOLARSHIP APPLICATION Military Spouse ELIGIBILITY: 2018 SCHOLARSHIP APPLICATION Military Spouse To be eligible for this scholarship program you must meet the following criteria: 1) Applicant must be the spouse of an Active Duty Navy, Marine

More information

Auxiliary New Member Course

Auxiliary New Member Course Auxiliary New Member Course INSTRUCTOR GUIDE NOT FOR GENERAL DISTRIBUTION HR PERSONNEL ONLY PUBLISHED FOR EDUCATIONAL PURPOSES ONLY COMDTPUB P16794.39B 12/13/2010 NEW MEMBER COURSE - INSTRUCTOR GUIDE

More information

INSTRUCTIONS FOR REQUESTING AN AFOSI LEOSA ID CARD Updated: 1 February 2018

INSTRUCTIONS FOR REQUESTING AN AFOSI LEOSA ID CARD Updated: 1 February 2018 INSTRUCTIONS FOR REQUESTING AN AFOSI LEOSA ID CARD Updated: 1 February 2018 As of February 2016, we no longer require weapons qualification documents for LEOSA ID packages. These instructions have been

More information

Prospective Member Guide

Prospective Member Guide Prospective Member Guide BE PART OF THE ACTION! "TEAM COAST GUARD" United States Coast Guard Auxiliary 9 th. District, Eastern Region Division 03, Flotilla 02 Hamburg, NY 14059 www.wnyboatsafe.org 1 Table

More information

BURLESON COUNTY SHERIFF S OFFICE

BURLESON COUNTY SHERIFF S OFFICE BURLESON COUNTY SHERIFF S OFFICE EMPLOYMENT APPLICATION DEPARTMENT USE ONLY APPLICANT: POSITION: DATE RECEIVED: INTERVIEW DATE: TIME: RATING: 1 2 3 4 5 6 7 8 9 10 AUTHORITY INSTRUCTIONS FOR APPLICATION

More information

2017 NOSC SCHOLARSHIP APPLICATION A High School Senior

2017 NOSC SCHOLARSHIP APPLICATION A High School Senior 2017 NOSC SCHOLARSHIP APPLICATION A High School Senior Naples Overseas Spouse Club (NOSC) scholarships are made possible through NOSC sponsored activities, such as the NOSC Thrift Store, in which volunteers

More information

Eighth Western Rivers. U. S. Coast Guard Auxiliary Officers & District Policies Guide. Revision

Eighth Western Rivers. U. S. Coast Guard Auxiliary Officers & District Policies Guide. Revision a. Eighth Western Rivers U. S. Coast Guard Auxiliary Officers & District Policies Guide Revision 2013.1 21 SEP 2012 (THIS PAGE LEFT BLANK) 16970 21 September 2012 From: Director of Auxiliary, Eighth Western

More information

Operational Facility Review

Operational Facility Review Operational Facility Review Prepared by Mike Lauro DSO-VE 11NR The D11NR Vessel Examiners Save Lives! 1 Operational Facility Decal 2 VSC Decal 1. 3 Introduction This module will present you with the forms

More information

Anderson County Sherif f s Department

Anderson County Sherif f s Department Anderson County Sherif f s Department The Robert Jolly Office Building 101 South Main Street, Suite 400 Clinton, Tennessee 37716 NOTICE: INCOMPLETE INFORMATION WILL RESULT IN THE DELAY OF THE PROCESSING

More information

IOS - Recruitment and Testing Services

IOS - Recruitment and Testing Services Westchester Police Department Application Instructions Thank you for your interest in the Westchester Police Department. Please be sure to carefully review all application instructions and testing information.

More information

STATE CERTIFICATION APPLICATION

STATE CERTIFICATION APPLICATION GEORGIA FIREFIGHTER STANDARDS AND TRAINING COUNCIL STATE CERTIFICATION APPLICATION Candidate Name GFSTC ID# TO BE MAINTAINED LOCALLY BY FIRE DEPARTMENT/AGENCY AND AVAILABLE FORE REVIEW BY GFSTC STAFF O.C.G.A.

More information

Employment Application Fulshear Simonton Fire Department

Employment Application Fulshear Simonton Fire Department Employment Application Please keep the following in mind while completing the application. 1. Please read each question and all instructions carefully while completing the application. Answer all questions

More information

SHERIFF OF GARFIELD COUNTY LOU VALLARIO

SHERIFF OF GARFIELD COUNTY LOU VALLARIO SHERIFF OF GARFIELD COUNTY LOU VALLARIO 107 8 TH Street Glenwood Springs, CO 81601 Phone: 970-945-0453 Fax: 970-945-7700 106 County Road 333-A Rifle, CO 81650 Phone: 970-665-0200 Fax: 970-665-0253 Dear

More information

VOLUNTEER FIREFIGHTER APPLICATION

VOLUNTEER FIREFIGHTER APPLICATION GEORGIA FIREFIGHTER STANDARDS AND TRAINING COUNCIL VOLUNTEER FIREFIGHTER APPLICATION Candidate Name GFSTC ID# TO BE MAINTAINED LOCALLY BY FIRE DEPARTMENT/AGENCY AND AVAILABLE FORE REVIEW BY GFSTC STAFF

More information

GEORGIA PEACE OFFICER STANDARDS AND TRAINING COUNCIL

GEORGIA PEACE OFFICER STANDARDS AND TRAINING COUNCIL GEORGIA PEACE OFFICER STANDARDS AND TRAINING COUNCIL APPLICATION FOR CERTIFICATION This application complies with the requirements of O.C.G.A. 35-8-7.1, 35-8- 8, and 35-8-10. Failure to complete all portions

More information

SECTION A PERSONAL INFORMATION

SECTION A PERSONAL INFORMATION Emergency Medical Services Provider Certification Application (Please print legibly) SECTION A PERSONAL INFORMATION Last Name First Name Middle Initial Suffix (Jr, Sr, II, III) Mailing Address City State

More information

CITY OF SLAYTON Application for Police Service APPENDIX A

CITY OF SLAYTON Application for Police Service APPENDIX A CITY OF SLAYTON Application for Police Service APPENDIX A Directions: 1. PRINT clearly and give complete and accurate information. If you do not, you may be removed from further consideration. USE BLACK

More information

Applicant Information

Applicant Information POSITION APPLIED FOR: DATE City of Coos Bay at your service Applicant Information NAME Last First Middle ADDRESS CITY STATE ZIP TELEPHONE Home Message Work Cellular Best time to call: At work At home May

More information

CITY OF BRANDON POLICE DEPARTMENT APPLICATION FOR EMPLOYMENT. ALL applicants MUST attach items 1, 2, 3, 4 I. PERSONAL HISTORY

CITY OF BRANDON POLICE DEPARTMENT APPLICATION FOR EMPLOYMENT. ALL applicants MUST attach items 1, 2, 3, 4 I. PERSONAL HISTORY CITY OF BRANDON POLICE DEPARTMENT APPLICATION FOR EMPLOYMENT MAIL OR DELIVER TO: THE CITY OF BRANDON 1000 MUNICIPAL DRIVE P.O. BOX 1539 BRANDON, MS 39043 ATTN: PERSONNEL Date: Notice: Application MUST

More information

Carlisle Police Department Employment Application

Carlisle Police Department Employment Application Employment Application POLICE OFFICER APPLICATION Carlisle Police Department 195 N. First Street Carlisle, IA 50047 (515)-989-4121 CARLISLE POLICE DEPARTMENT Instruction for Applicants **Please do Not

More information

Introduction. Documentation Packet. Oral Board. PQS Verification. For some tasks, you must present evidence such as published articles and pictures.

Introduction. Documentation Packet. Oral Board. PQS Verification. For some tasks, you must present evidence such as published articles and pictures. Revised February 2016 Introduction his workbook and accompanying guide is designed to help you become a Coast Guard Auxiliary Public Affairs Specialist. There are three levels of certification. Specialist

More information

Maine Human Resources Office Technician Vacancy Announcement Guide

Maine Human Resources Office Technician Vacancy Announcement Guide Maine Human Resources Office Technician Vacancy Announcement Guide Background of the Technician Program. The Maine National Guard Technician Program is Federal Civil Service employment. Positions are available

More information

Jefferson County Sheriff s Office 200 Courthouse Way, Rigby, ID PH# ~ FX#

Jefferson County Sheriff s Office 200 Courthouse Way, Rigby, ID PH# ~ FX# Jefferson County Sheriff s Office 200 Courthouse Way, Rigby, ID 83442 PH# 208-745-9210 ~ FX# 208-745-9212 JOB APPLICATION Name: Application Date POSITION APPLIED FOR: Patrol Jail Dispatch Reserve Application

More information

Crandall Fire Department

Crandall Fire Department Crandall Fire Department Membership Application Today s Date Please Print or Type all information. All printing must be in BLUE ink. Omissions and/or false information are cause for rejection or dismissal.

More information

Italian Visa Requirements

Italian Visa Requirements Italian Visa Requirements International Programs - Florence Florence Academic Year 18-19 and Fall Only Students Students attending Florence, Italy for the Academic Year are required to have a student visa.

More information

PLYMOUTH POLICE DEPARTMENT POLICE OFFICER EMPLOYMENT POLICIES

PLYMOUTH POLICE DEPARTMENT POLICE OFFICER EMPLOYMENT POLICIES PLYMOUTH POLICE DEPARTMENT POLICE OFFICER EMPLOYMENT POLICIES REQUIREMENTS Must be a citizen of the United States of America Must be at least 21 and may not have reached your 36th birthday by date of appointment

More information

SHERIFF, OHIO COUNTY 51 Sixteenth Street, Wheeling, West Virginia Law Enforcement Records

SHERIFF, OHIO COUNTY 51 Sixteenth Street, Wheeling, West Virginia Law Enforcement Records SHERIFF, OHIO COUNTY 51 Sixteenth Street, Wheeling, West Virginia 26003 Law Enforcement 304-234-3680 Records 304-234-3792 Re: Sheriff s Office Applicants Chief Deputy Drage Flick Special Information The

More information

Professional Credential Services, Inc.

Professional Credential Services, Inc. Professional Credential Services, Inc. P.O. Box 198689 - Nashville, TN 37219-8689 www.pcshq.com Licensure Application for Athletic Trainers For the Massachusetts Board of Allied Health Professionals If

More information

INTENT TO APPLY FOR PROVISIONAL PROVIDER LISTING VIA THE JUDICIAL RURAL INITIATIVE

INTENT TO APPLY FOR PROVISIONAL PROVIDER LISTING VIA THE JUDICIAL RURAL INITIATIVE INTENT TO APPLY FOR PROVISIONAL PROVIDER LISTING VIA THE JUDICIAL RURAL INITIATIVE COLORADO DOMESTIC VIOLENCE OFFENDER MANAGEMENT BOARD COLORADO DEPARTMENT OF PUBLIC SAFETY DIVISION OF CRIMINAL JUSTICE

More information

Adams County Court for Veterans Mentoring Program Information Sheet

Adams County Court for Veterans Mentoring Program Information Sheet Adams County Court for Veterans Mentoring Program Information Sheet Mission Statement: The mission of the Veterans Mentoring Program is to make certain to the best of our ability that No Veteran is Left

More information

7547 Main Street John R. Williams, Jr. Sykesville, Maryland Police

7547 Main Street John R. Williams, Jr. Sykesville, Maryland Police Sykesville Police Department 7547 Main Street John R. Williams, Jr. Sykesville, Maryland 21784 Chief of Police Phone: (410) 795-0757 EMPLOYMENT OPPORTUNITIES LATERAL POLICE OFFICERS Chief John R. Williams

More information

Recruiting Team Resources

Recruiting Team Resources Subjects Recruiting Team Referrals from National Website New Member Process Retention is a must for excellence Disenrollment Procedures Transfer of Membership Recruiting is always needed Recruiting Team

More information

Department of Defense INSTRUCTION. References: (a) DoD Instruction , subject as above, September 21, 1956 (hereby canceled)

Department of Defense INSTRUCTION. References: (a) DoD Instruction , subject as above, September 21, 1956 (hereby canceled) Department of Defense INSTRUCTION NUMBER 1304.2 March 14, 1975 ASD(M&RA) SUBJECT: Instruction Pre-enlistment Forms References: (a) DoD Instruction 1304.2, subject as above, September 21, 1956 (hereby canceled)

More information

STEUBEN COUNTY SHERIFF S OFFICE

STEUBEN COUNTY SHERIFF S OFFICE STEUBEN COUNTY SHERIFF S OFFICE CONFINEMENT OFFICER APPLICATION APPLICANT NAME DATE SUBMITTED Return in a sealed envelope or in person to: CAPTAIN JASON HUFNAGLE STEUBEN COUNTY JAIL COMMANDER 206 E GALE

More information

FORM N-100 FOR TANZANIAN LOCAL SUPPLIERS AND SERVICE PROVIDERS (LSSP) DATABASE IN THE PETROLEUM SUBSECTOR

FORM N-100 FOR TANZANIAN LOCAL SUPPLIERS AND SERVICE PROVIDERS (LSSP) DATABASE IN THE PETROLEUM SUBSECTOR FORM N-100 FOR TANZANIAN LOCAL SUPPLIERS AND SERVICE PROVIDERS (LSSP) DATABASE IN THE PETROLEUM SUBSECTOR For EWURA use Only Remarks Date Stamp Receipt Action Block Type or print in black ink. Type or

More information

Private Investigator and/or Security Guard Qualifying Agent Application

Private Investigator and/or Security Guard Qualifying Agent Application Vermont Secretary of State Office of Professional Regulation 89 Main Street, 3 rd Floor Montpelier VT 05620-3402 Kara Shangraw Licensing Board Specialist (802) 828-1134 kara.shangraw@sec.state.vt.us www.vtprofessionals.org

More information

APPLICATION 1 First Application for Associate Level

APPLICATION 1 First Application for Associate Level Colorado Sex Offender Management Board (SOMB) APPLICATION 1 First Application for Associate Level for Placement on the Adult and/or Juvenile Provider List Treatment Provider and/or Evaluator Colorado Department

More information

New Substitute Paraprofessional or Secretary Fingerprint-Based Criminal Background Check Procedures

New Substitute Paraprofessional or Secretary Fingerprint-Based Criminal Background Check Procedures New Substitute Paraprofessional or Secretary Fingerprint-Based Criminal Background Check Procedures You are required to have a fingerprint-based criminal history check. The Tazewell Regional Office of

More information

Military Reference Guide

Military Reference Guide Missouri DEPARTMENT OF REVENUE Military Reference Guide Revised February 2011 Missouri Department of Revenue Contact Information MILITARY LIAISON The Missouri Department of Revenue has designated a Military

More information

MONROE COUNTY SHERIFF S OFFICE APPLICANT INFORMATION SUMMARY

MONROE COUNTY SHERIFF S OFFICE APPLICANT INFORMATION SUMMARY Name (print or type): Date Received Position Applied For: by MCSO: MONROE COUNTY SHERIFF S OFFICE APPLICANT INFORMATION SUMMARY INTEGRITY RESPECT SERVICE DIVERSITY HONOR STATEMENT OF EQUAL EMPLOYMENT OPPORTUNITY

More information

Okinawa Enlisted Spouses Club Non-Military Spouse Scholarship Guidelines 2015

Okinawa Enlisted Spouses Club Non-Military Spouse Scholarship Guidelines 2015 Sharing is Caring Okinawa Enlisted Spouses Club Non-Military Spouse Scholarship Guidelines 2015 The Okinawa Enlisted Spouses Club (OESC) is a private organization designed to benefit families of military

More information

Georgia Peace Officer Standards & Training Council CERTIFICATION OF CANDIDATE PAGE 1

Georgia Peace Officer Standards & Training Council CERTIFICATION OF CANDIDATE PAGE 1 CERTIFICATION OF CANDIDATE PAGE 1 Projected Academy: Projected Academy Start Date Notify POST via e-mail if actual start date is different from this projection. Candidate s Last Name Candidate s First

More information

Application Form. Two copies of government issued identification. Two recent passport photos of yourself that are no more than six months old.

Application Form. Two copies of government issued identification. Two recent passport photos of yourself that are no more than six months old. Application Form IMPORTANT: You must submit along with this form Verification of Experience Form. Verification of Experience Form and this Application form must be signed and submitted together with all

More information

GEORGIA PEACE OFFICER STANDARDS AND TRAINING COUNCIL

GEORGIA PEACE OFFICER STANDARDS AND TRAINING COUNCIL GEORGIA PEACE OFFICER STANDARDS AND TRAINING COUNCIL APPLICATION FOR PRE-SERVICE TRAINING Return to: GEORGIA PEACE OFFICER STANDARDS AND TRAINING COUNCIL P.O. Box 349 Clarkdale, Georgia 30111 FOREWORD

More information

Teddy Forstmann Scholarship Program Application Instructions

Teddy Forstmann Scholarship Program Application Instructions 2015-2016 Application Instructions APPLICATION DEADLINE: FRIDAY, AUGUST 21, 2015,,. Applications postmarked AFTER this deadline may not be awarded. Please be sure to keep in contact regularly with your

More information

NATIONAL GUARD BUREAU 111 SOUTH GEORGE MASON DRIVE ARLINGTON VA ARNG-HRR 25 July 2018

NATIONAL GUARD BUREAU 111 SOUTH GEORGE MASON DRIVE ARLINGTON VA ARNG-HRR 25 July 2018 NATIONAL GUARD BUREAU 111 SOUTH GEORGE MASON DRIVE ARLINGTON VA 22204-1382 ARNG-HRR 25 July 2018 MEMORANDUM FOR NG J1 RRF (All-Entire RRF) SUBJECT: SMOM 18-069, Updated Prior Service Field Enlistment Checklist

More information

Professional Credential Services, Inc.

Professional Credential Services, Inc. Professional Credential Services, Inc. P.O. Box 198689 - Nashville, TN 37219-8689 www.pcshq.com Licensure Application for Occupational Therapists For the Massachusetts Board of Allied Health Professionals

More information

Please keep this sheet for your records

Please keep this sheet for your records Air Force Officers Spouses Club of Washington, D.C. Spouse Scholarship Application 2017-2018 General Information/Criteria: 1. The Air Force Officers Spouses Club (AFOSC) awards merit-based scholarships

More information

Charting your course for service in the United States Coast Guard Auxiliary NEW MEMBER HANDBOOK

Charting your course for service in the United States Coast Guard Auxiliary NEW MEMBER HANDBOOK Charting your course for service in the United States Coast Guard Auxiliary NEW MEMBER HANDBOOK PLEASE NOTE: Publications maintained by the Human Resources Directorate are currently under review for accuracy,

More information

Application for Employment Police Cadet

Application for Employment Police Cadet Halton Regional Police Service Application for Employment Police Cadet Dear Applicant: Return application package with photocopies of the following documents if you have not already provided them: OACP

More information

CHAPTER 1. MEMBERSHIP

CHAPTER 1. MEMBERSHIP CHAPTER 1. MEMBERSHIP A. Enrollments. 1. New Member Enrollments. New member enrollment requests will be submitted by the Flotilla Commander (FC) to the Director of Auxiliary (DIRAUX). Enrollment request

More information

Spouses Club Scholarship Committee of SJAFB High School Class of 2017 Scholarship Application

Spouses Club Scholarship Committee of SJAFB High School Class of 2017 Scholarship Application Spouses Club Scholarship Committee of SJAFB High School Class of 2017 Scholarship Application General Information/Criteria: 1. The Spouses Club Scholarship Committee (SCSC) offers merit-based scholarships

More information

Town of Billerica Police Department 6 Good Street Billerica, Ma (978) Fax (978)

Town of Billerica Police Department 6 Good Street Billerica, Ma (978) Fax (978) Town of Billerica Police Department 6 Good Street Billerica, Ma 01821 (978) 671-0900 Fax (978) 663-2392 www.billericapolice.org BILLERICA POLICE DEPARTMENT POLICE CANDIDATE APPLICATION FOR EMPLOYMENT In

More information

APPLICATION FOR BURGLAR ALARM LICENSE (IN ACCORDANCE WITH G.S. 74D) [Type or Print in Black Ink] 1. Name First Middle (Maiden) Last (Nickname)

APPLICATION FOR BURGLAR ALARM LICENSE (IN ACCORDANCE WITH G.S. 74D) [Type or Print in Black Ink] 1. Name First Middle (Maiden) Last (Nickname) NORTH CAROLINA ALARM SYSTEMS LICENSING BOARD 3101 Industrial Drive Suite 104 Raleigh, North Carolina 27609 Phone: (919) 788-5320 Fax: (919) 788-5365 E-Mail: PPSASL@ncdps.gov www.ncdps.gov/asl.aspx APPLICATION

More information

!! PLEASE WRITE VERY CLEARLY TO AVOID PROCESSING DELAYS!!

!! PLEASE WRITE VERY CLEARLY TO AVOID PROCESSING DELAYS!! International Student Financial Verification Form International Programs (IP) at Clayton State University requires each international applicant to document their ability to fund the first full year of

More information

NEW MEMBER HANDBOOK. Charting your course for service in the United States Coast Guard Auxiliary

NEW MEMBER HANDBOOK. Charting your course for service in the United States Coast Guard Auxiliary United States Coast Guard Auxiliary NEW MEMBER HANDBOOK Charting your course for service in the United States Coast Guard Auxiliary U.S. Coast Guard Auxiliary Human Resources Directorate Revised 1 December

More information

APPLICATION FOR WYOMING NURSING ASSISTANT CERTIFICATION (CNA) *All licenses expire December 31 of every EVEN year*

APPLICATION FOR WYOMING NURSING ASSISTANT CERTIFICATION (CNA) *All licenses expire December 31 of every EVEN year* APPLICATION FOR WYOMING NURSING ASSISTANT CERTIFICATION (CNA) *All licenses expire December 31 of every EVEN year* This is a Legal Document. By completing and signing this document, you certify, under

More information

INSTRUCTIONS AND INFORMATION APPLICATION FOR INITIAL NURSE LICENSURE BY EXAMINATION

INSTRUCTIONS AND INFORMATION APPLICATION FOR INITIAL NURSE LICENSURE BY EXAMINATION Revised April 4. 2016 The Commonwealth of Massachusetts Executive Office of Health and Human Services Department of Public Health Division of Health Professions Licensure Board of Registration in Nursing

More information

Pennsylvania Certification by Reinstatement

Pennsylvania Certification by Reinstatement Pennsylvania Certification by Reinstatement Thank you for your interest in obtaining current registration of your Pennsylvania EMS Certification. This is the process whereby a person expired Pennsylvania

More information

1. NAME Last First Middle 2. TITLE (e.g., M.D., LMFT) 3. SOCIAL SECUTIRY NO. 4. PERMANENT ADRESS STREET CITY STATE/COUNTRY ZIP CODE COUNTY

1. NAME Last First Middle 2. TITLE (e.g., M.D., LMFT) 3. SOCIAL SECUTIRY NO. 4. PERMANENT ADRESS STREET CITY STATE/COUNTRY ZIP CODE COUNTY Application for Certified Family Therapist USA and Canadian marriage and family therapy license holders. This application is specifically for licensed marriage and family therapist in the United States

More information

EDUCATION ENROLMENT FORM EXPRESSION OF INTEREST

EDUCATION ENROLMENT FORM EXPRESSION OF INTEREST Office Use Only Eligible for Funding Reason: Yes No EDUCATION ENROLMENT FORM EXPRESSION OF INTEREST Office Use Only Student Number: Enrolment Complete: Yes No Course: Classroom: Start Date: Documents uploaded

More information

INSTRUCTIONS FOR COMPLETION OF DD FORM , APPLICATION FOR IDENTIFICATION CARD/DEERS ENROLLMENT

INSTRUCTIONS FOR COMPLETION OF DD FORM , APPLICATION FOR IDENTIFICATION CARD/DEERS ENROLLMENT INSTRUCTIONS FOR COMPLETION OF DD FORM 1172-2, APPLICATION FOR IDENTIFICATION CARD/DEERS ENROLLMENT SECTION I SPONSOR/EMPLOYEE INFORMATION Block 1. Name. Enter the Attaché/employee s LAST name first (Surname

More information

COUNTY OF SACRAMENTO Probation Department

COUNTY OF SACRAMENTO Probation Department COUNTY OF SACRAMENTO Probation Department 9750 BUSINESS PARK DRIVE, SUITE 220, SACRAMENTO, CALIFORNIA 95827 TELEPHONE (916) 875-0273 FAX (916) 875-0347 LEE SEALE CHIEF PROBATION OFFICER COUNTY PAROLE OFFICER

More information

Southwest Florida Public Service Academy 4312 E. Michigan Ave. Ft. Myers FL Tel: (239) Fax: (239)

Southwest Florida Public Service Academy 4312 E. Michigan Ave. Ft. Myers FL Tel: (239) Fax: (239) Southwest Florida Public Service Academy 4312 E. Michigan Ave. Ft. Myers FL 33905 Tel: (239) 334-3897 Fax: (239) 334-8794 Todd Everly, Director Robert Martin III, Corrections Coordinator Jack Thomson,

More information

CRIMINAL BACKGROUND CHECK by Division of Criminal Investigation (DCI)

CRIMINAL BACKGROUND CHECK by Division of Criminal Investigation (DCI) *All licenses expire December 31 of every EVEN year* This is a Legal Document. By completing and signing this document, you certify, under penalty of perjury and subject to the provisions of Wyo. Stat.

More information

CNA Course Snow College West Campus, Ephraim UT & Juab Campus

CNA Course Snow College West Campus, Ephraim UT & Juab Campus CNA Course Snow College West Campus, Ephraim UT & Juab Campus *If you have any questions or concerns or need assistance getting started PLEASE contact Jennifer Bushman! 1. Registration Form Fill out above

More information

Massage Therapist License Application W 87 Street Pkwy Phone Lenexa, KS Fax

Massage Therapist License Application W 87 Street Pkwy Phone Lenexa, KS Fax Massage Therapist License Application 17101 W 87 Street Pkwy Phone 913-477-7725 Lenexa, KS 66109 Fax 913-477-7730 www.lenexa.com NOTE: Any failure to fully or truthfully answer any question or provide

More information

Iowa Central Community College Health Science Office-Nursing Attention: Emily Holtapp One Triton Circle Fort Dodge, IA 50501

Iowa Central Community College Health Science Office-Nursing Attention: Emily Holtapp One Triton Circle Fort Dodge, IA 50501 Dear Advanced Standing Nursing student: Thank you for applying to the Advanced Standing Nursing program at Iowa Central Community College. In order to be considered for second level of the nursing program

More information

FIREARMS TRAINING COURSE REQUIREMENTS TO OBTAIN A FIREARMS QUALIFICATION CARD

FIREARMS TRAINING COURSE REQUIREMENTS TO OBTAIN A FIREARMS QUALIFICATION CARD FIREARMS TRAINING COURSE REQUIREMENTS TO OBTAIN A FIREARMS QUALIFICATION CARD The California Private Security Industry is governed by laws enacted by the California Legislature and contained in the California

More information

Georgia Peace Officer Standards & Training Council CERTIFICATION OF CANDIDATE PAGE 1

Georgia Peace Officer Standards & Training Council CERTIFICATION OF CANDIDATE PAGE 1 CERTIFICATION OF CANDIDATE PAGE 1 Candidate s Last Name Candidate s First Name Candidate s Middle Name Name Suffix (Sr., Jr., II, III, etc.) Social Sec# Maiden Name RACE Education (select highest level

More information

A Public Service Sorority Atlanta Alumnae Chapter

A Public Service Sorority Atlanta Alumnae Chapter A Public Service Sorority Atlanta Alumnae Chapter SCHOLARSHIP APPLICATION PACKET Application Instructions Please type or print the application legibly in black or blue ink Applications must be submitted

More information

St. Vincent Apartments 1521 Las Vegas Blvd. North Las Vegas, NV 89101

St. Vincent Apartments 1521 Las Vegas Blvd. North Las Vegas, NV 89101 St. Vincent Apartments 1521 Las Vegas Blvd. North Las Vegas, NV 89101 APPLICATION FOR RENTAL A. Applicant Information DATE Catholic Charities is required to verify that all tenants of the St. Vincent Apartments

More information

Pennsylvania Certification by Endorsement

Pennsylvania Certification by Endorsement Pennsylvania Certification by Endorsement Thank you for your interest in obtaining Pennsylvania EMS Certification by Endorsement. This is the process whereby a person certified by another state other than

More information

Spring 2006 Hazlewood Exemption Application Packet for Eligible Dependents of Texas Members of the U.S. Armed Forces Who have Never Used the Exemption

Spring 2006 Hazlewood Exemption Application Packet for Eligible Dependents of Texas Members of the U.S. Armed Forces Who have Never Used the Exemption Spring 2006 Hazlewood Exemption Application Packet for Eligible Dependents of Texas Members of the U.S. Armed Forces Who have Never Used the Exemption Form HE-SP06D and Instructions Spring 2006 Hazlewood

More information

CITY OF GLADSTONE APPLICATION FOR EMPLOYMENT (An Equal Opportunity Employer)

CITY OF GLADSTONE APPLICATION FOR EMPLOYMENT (An Equal Opportunity Employer) ~C t y i M o f i s G s l o a u d r s i t o n e ~ CITY OF GLADSTONE APPLICATION FOR EMPLOYMENT (An Equal Opportunity Employer) In keeping with our commitment to maintain a drug and alcohol-free workplace,

More information

UNCLASSIFIED ID Card USV-JSC 1000 RECORD OF CHANGE DATE ENTERED

UNCLASSIFIED ID Card USV-JSC 1000 RECORD OF CHANGE DATE ENTERED UNCLASSIFIED ID Card USV-JSC 1000 RECORD OF CHANGE CHANGE NUMBER COPY NUMBER DATE OF CHANGE DATE ENTERED POSTED BY REMARKS In accordance with the procedures contained herein, change recommendations to

More information

Cahokia Volunteer Fire Department. Application for Membership

Cahokia Volunteer Fire Department. Application for Membership Cahokia Volunteer Fire Department Application for Membership Minimum Requirements for Membership 1) Must be a resident within the residential boundaries for at least 6 months. 2) Must be a minimum age

More information

APPLICATION FOR WYOMING NURSING ASSISTANT CERTIFICATION (CNA) *All licenses expire December 31 of every EVEN year*

APPLICATION FOR WYOMING NURSING ASSISTANT CERTIFICATION (CNA) *All licenses expire December 31 of every EVEN year* APPLICATION FOR WYOMING NURSING ASSISTANT CERTIFICATION (CNA) *All licenses expire December 31 of every EVEN year* This is a Legal Document. By completing and signing this document, you certify, under

More information

INSTRUCTIONS FOR COMPLETION OF ADVANCED PRACTICE APPLICATION

INSTRUCTIONS FOR COMPLETION OF ADVANCED PRACTICE APPLICATION KANSAS STATE BOARD OF NURSING Landon State Office Building 900 SW Jackson, Ste 1051 Topeka, KS 66612-1230 (785) 296-4929 INSTRUCTIONS FOR COMPLETION OF ADVANCED PRACTICE APPLICATION Licensure in Kansas

More information

Carefully read the following information, application instructions, and the NCLEX Candidate Bulletin prior to completing the enclosed application.

Carefully read the following information, application instructions, and the NCLEX Candidate Bulletin prior to completing the enclosed application. Executive Office of Health and Human Services Department of Public Health Bureau of Health Professions Licensure Board of Registration in Nursing www.mass.gov/dph/boards/rn The Commonwealth of Massachusetts

More information

Delta Sigma Theta Sorority, Inc. Cincinnati Alumnae Chapter

Delta Sigma Theta Sorority, Inc. Cincinnati Alumnae Chapter 2014 2015 Application Packet 2014 2015 COTILLION OVERVIEW For nearly 20 years, the (CAC) of has been formally presenting young high school ladies to society and the Cincinnati community through its annual

More information

Appendix F. Auxiliarist-of-the-Year and Commodore Greanoff Inspirational Leadership Award Nomination Package Formats

Appendix F. Auxiliarist-of-the-Year and Commodore Greanoff Inspirational Leadership Award Nomination Package Formats Appendix F. Auxiliarist-of-the-Year and Commodore Greanoff Inspirational Leadership Award Nomination Package Formats In this Appendix This appendix contains the following information: Topic See Page AUXOY

More information

DIVISION OF PROFESSIONAL LICENSURE BOARD OF CERTIFICATION OF OPERATORS OF DRINKING WATER SUPPLY FACILITIES

DIVISION OF PROFESSIONAL LICENSURE BOARD OF CERTIFICATION OF OPERATORS OF DRINKING WATER SUPPLY FACILITIES The Commonwealth of Massachusetts DIVISION OF PROFESSIONAL LICENSURE BOARD OF CERTIFICATION OF OPERATORS OF DRINKING WATER SUPPLY FACILITIES 1000 Washington Street, Suite 710 Boston, Massachusetts 02118

More information

Please attach 2x3 color photo here

Please attach 2x3 color photo here Please attach 2x3 color photo here 2012-2013 Debutante Cotillion and Scholarship Program Sponsored by RPO, Inc. in conjunction with the Alpha Kappa Alpha Sorority, Inc. Rho Psi Omega Chapter PROSPECTIVE

More information

Springfield Police Department

Springfield Police Department PLEASE NOTE: Applications will be accepted beginning May 15, 2018, and the deadline for applications will be June 20, 2018. Press Release Chief of Police John P. Cook has announced the dates for the 2018

More information

Application for Admission to the Texas A&M Maritime Academy 2019

Application for Admission to the Texas A&M Maritime Academy 2019 Application for Admission to the Texas A&M Maritime Academy 2019 1 INSTRUCTIONS This application should be completed by all students who wish to participate in the Texas A&M Maritime Academy (TAMMA). All

More information

AUXILIARY SEARCH, COORDINATION, AND EXECUTION (AUXSC&E) COURSE TRAINING POLICY

AUXILIARY SEARCH, COORDINATION, AND EXECUTION (AUXSC&E) COURSE TRAINING POLICY Version 1.3 1. Purpose This document provides policy and guidance concerning the locally convened Auxiliary Search, Coordination, and Execution (AUXSCE) specialty course, the Train the Trainer (TTT) course,

More information

Present Address Telephone ( ) Street City State Zip. Permanent Address Telephone ( ) Social Security Number / / address

Present Address Telephone ( ) Street City State Zip. Permanent Address Telephone ( ) Social Security Number / /  address Application for Classified Personnel Minden Public Schools An Equal Opportunity/Affirmative Action Employer 543 West Third Phone: (308) 832-2440 Minden, NE 68959 Fax: (308) 832-2567 Please type or print

More information

Bring these four items with you to:

Bring these four items with you to: U N I V E R S I T Y O F H A W A I I A T M A N O A College of Education Institute for Teacher Education Fingerprinting and Background Check Requirement Students enrolled in the College of Education conduct

More information

Quakertown Fire Company, Pittstown, NJ. Franklin Township Fire District No. 1 of Hunterdon County

Quakertown Fire Company, Pittstown, NJ. Franklin Township Fire District No. 1 of Hunterdon County Quakertown Fire Company, Pittstown, NJ Application for Active Membership Franklin Township Fire District No. 1 of Hunterdon County Release and Consent Form authorizing the Franklin Township Fire District

More information

Spouses Club Scholarship Committee of SJAFB Current College Student Scholarship Application

Spouses Club Scholarship Committee of SJAFB Current College Student Scholarship Application Spouses Club Scholarship Committee of SJAFB Current College Student Scholarship Application 2017 2018 General Information/Criteria: 1. The Spouses Club Scholarship Committee (SCSC) offers merit-based scholarships

More information

CITY OF MISSION CIVIL SERVICE APPLICATION

CITY OF MISSION CIVIL SERVICE APPLICATION CITY OF MISSION CIVIL SERVICE APPLICATION City of Mission Civil Service Department 1201 E. 8 th Street Mission, TX 78572 Applicant Name: Position Applying For: Police Officer Fire Fighter Page 1 of 15

More information

AmeriCorps Application Packet

AmeriCorps Application Packet AmeriCorps Application Packet Dear Friend, Fill out the application to the best of your ability. Must be 18 years or older with a High School Diploma or GED to apply. Must be a U.S. Citizen or National

More information

Baton Rouge Community College Scholarship Application

Baton Rouge Community College Scholarship Application Baton Rouge Community College Scholarship Application Application Deadline: Friday, June 16, 2017 PURPOSE The Baton Rouge Community College Foundation, Inc. (BRCC Foundation) is a non-profit corporation

More information

( ) Course Code 482 Edition 18 U. S. COAST GUARD AUXILIARY AUXILIARY NEW MEMBER COURSE EXAMINATION INSTRUCTIONS

( ) Course Code 482 Edition 18 U. S. COAST GUARD AUXILIARY AUXILIARY NEW MEMBER COURSE EXAMINATION INSTRUCTIONS (03-2010) Course Code 482 Edition 18 U. S. COAST GUARD AUXILIARY AUXILIARY NEW MEMBER COURSE EXAMINATION INSTRUCTIONS l. Check the subject of this examination to be sure that this is the one requested.

More information