Your ticket details
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General Information 
 
Full Name
Email
Priority

Auxiliary Member's Information 
 
District:
Member's District:
Flotilla:
Member's Flotilla
Auxiliary Office:
Member's Auxiliary Office, if any.

USCG Auxiliary Forms 
 
Form Type:*




Form Number:*
Use the form number shown in the Forms Wareshouse http://forms.cgaux.org
Form Revision Number:*
The Revision Number is shown in upper-right corner in grey.
Computer Type (PC/Mac/Other):*
PC/Mac/Other
Operating System::*
e.g. "Windows XP", "Mac OS X 10.6"
PDF Software/version:*
e.g. "Adobe Reader X, 10.1.2"

Message Details 
 
Subject
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