U.S. Coast Guard Auxiliary National Web Site

Flotilla 24-11 Application Form

If you would like to join our Auxiliary, please fill out the application form below:

Contact Information
First Name:  *** required field
Last Name:  *** required field
Email:   *** required field
Phone Number with area code:    format: XXX-XXX-XXXX *** required field
ZIP:  *** required field
Do you possess any of the following?
    Boating License/Certificate/Master's License
    Amateur Radio License
    VHF/HF/MF Radios
    Pilot's License
    Trade Skills
    Administrative Skills (secretary/assistant/accountant/etc.)
    Public Affairs & Speaking Experience
    Teaching (elementary/secondary/college) Experience
    First Aid/CPR/AED Certification
    Healthcare Provider or EMS/EMT/Paramedic Experience
    Prior Service

How did you hear about us?  

Thank you for applying!  We'll be in touch.