Enclosure (4) to COMDTINST 16798.2
COAST GUARD AUXILIARY
AIR CREW APPLICATION FORM
(To be completed by applicant)
Name____________________________
Member Number______________________
Flotilla________________________
ADDRESS:
Street_______________________________________________________
City_________________________ State______________Zip_________
Home Phone______________________________
Work Phone______________________________
Coast Guard Auxiliary Observer Qualified (Circle One):
Yes
No
Prior Aviation Experience (Circle One): Yes
No
(If Yes, Please Describe):
Availability - List availability for flights on week days, week ends, and
holidays:
(To be completed by DIRAUX)
Evaluate application with criteria listed in paragraph 5. a. (1) through
(4) of COMDTINST 16798.2:
Application Disposition:
(CIRCLE YES OR NO)
Accepted:
YES
NO
Denied:
YES
NO
Wait Listed:
YES
NO
If denied or wait listed, explain:
ANSC 7043