Auxilary Emblem Perspective Member Questionnaire




Please tell us a little about yourself by completing the following Perspective Member Questionnaire.

The United States Coast Guard is a volunteer service organization. We are a non-military 'arm' of Team Coast Guard. Auxiliarists are proud of their membership and training. In many areas, you will be the Coast Guard's only link with the public. This recognition is a Privilege as well as a Responsibility.

As auxiliarists, we volunteer time, talents, boats, radios, and aircraft. We are given special training in order to work effectively with the Coast Guard. The fellowship and satisfaction accompanying your activities are also a benefit from our service.

Please take a moment to reflect on the above while giving us some information about you. If you have any questions, the person that contacts you will be happy to answer them.



Name
Address
City
State
ZIP
Daytime Phone (XXX)XXX-XXXX format
Evening Phone
E-Mail
Best way to reach you: Daytime call
Evening call
E-Mail

If you own, or have access to a vessel/aircraft, please check that which most closely identifies its conformation:

POWER BOAT:
  gas
diesel

SAIL BOAT
   
Configuration:
Power Assist? YES NO

"OTHER" VESSELS
  Canoe Row Boat Flat Bottom "Johnboat"

AIRCRAFT
  Configuration:
  Single Engine Twin Engines

 
Years on the water: 0 to 5 6 to 10 11 to 15 more than 15
 
Experience in boat handling: Novice Some Experience Expert
 
Do you own a VHF radio station aside from that which is on your vessel? Yes No
 
What areas most interest you in your spare time? Check all that apply.
  Writing Public Speaking Public Affairs Music Art Administration Entertainment Computers Radio Operations Theater Dance Teaching Publications Communications Sports (involved) Sports (spectator) Sailing Power Boating Rowing Other
 
 
Briefly outline your reason(s) for considering membership in the United States Coast Guard Auxiliary
 
Please list any special talent(s) that may enhance your experience with the auxiliary:
 
As Auxiliarists, we receive optional, special training not offered to the general public. Please check all those below that interest you at this time. Remember, as you gain experience in the auxiliary, things change and your interests may also change. This will help us start you in some direction and thereby strive to make your participation in the Auxiliary as efficient and enjoyable as possible.
  Instructor Boat Crew Program Air Operations Other Operational Programs Marine Dealer Visitor Vessel Examiner Administration Seamanship Navigation Communications Search and Rescue Patrols Weather
 
Please include any comments you have:
 


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