Request for Information

Fill in the blanks below to receive information about the Iowa Wing, Civil Air Patrol. Thank you.

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Last Name:	Female:
Address:

City:
State:	Country:
Zip + 4:	Age:
Telephone:
Email:
*Parents Name:	Required for prospects under 18 years of age

How did you hear about CAP:


Type of Support You Are Interested In?


Training Interests: (Check All That Apply):

	Aerospace Education	Aircraft Marshalling
	Cadet Leadership Training	Chaplain / Moral Leadership
	Disaster Relief	Drill & Ceremonies
	Financial Management	Firearms Safety
	First Aid & CPR	Glider Program
	Homeland Security	Land Navigation
	Military Training	Model Rocketry
	Outdoor Skills	Professional Development
	Public Relations / Marketing	Radio Communications
	Search and Rescue - Aerial	Search and Rescue - Ground
	Web Training / Developer

Skills You Can Offer: (Check All That Apply):

	Aerospace Education Instructor	Firearms Safety Instructor
	Cadet Mentor	First Aid & CPR Instructor
	Radio Communications Instructor	Glider Instructor
	Power Flight Instructor	Pilot, Balloon
	Drill & Ceremonies Instructor	Retired Military
	Finance / Administration	Model Rocketry Instructor
	Land Navigation Instructor	Legal
	Legislative Liaison	Homeland Security
	Public Relations / Marketing	Pilot, Powered
	Outdoor Skills Instructor	Pilot, Powered Instrument
	Amateur Radio Operator	Amateur Radio, VE


Demographics: (Check All That Apply):

	AOPA Member	Air Force Association Member
	Aircraft Owner	Armed Forces Active Duty
	Armed Forces Reserve	Armed Forces National Guard
	Armed Forces Retired	EAA Member
	ARRL Member	FAA Certified Flight Instructor (CFI)
	Former CAP Member	NASAR Member
	Law Enforcement Officer	Pilot, FAA
	Soaring Society of America Member	Elected Official
	Lawyer	Health Services (Doctor, Nurse, EMT)
	Sales / Advertising	U.S. Coast Guard Auxiliary
	VFW / American Legion	American Red Cross
	Kiwanis	Rotary
	Firefighter	Clergy
	Student, Middle School	Student, High School
	Student, College (4 year)	Student, College (2 year)


Comments:

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"LINKS OR REFERENCES TO INDIVIDUALS OR COMPANIES DOES NOT CONSTITUTE AN ENDORSEMENT OF ANY INFORMATION, PRODUCT OR SERVICE YOU MAY RECEIVE FROM SUCH SOURCES."

Warning: The information you are receiving is protected from interception or disclosure. Any person who intentionally distributes, reproduces or discloses
its contents is subject to the penalties set forth in 18 United States Code Section 2511 and/or related state and federal laws of the United States.

This site was last updated on 07 March 2009, 11:53 -0600.
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