EmailMe Form - 9CR Auxiliary ID Application

9CR Auxiliary ID Application

Please complete all fields of this form and do not forget to upload a photo of you in front of a solid red background. A photo must be submitted with application. The '.jpeg' file must be identified by member name and Employee /ID#. New Members who are in AP Status (Applicant Pending) must wait until their status is IQ or BQ before submitting this application and photo. Members must have completed all mandatory training to receive a new card or have an old card renewed. For issues with the form please contact Lynda Stolt. Email: lyndastolt@gmail.com

Member Name *
First-Full Middle-Last
Member Number *
Enter your 7 digit member(employee) number
Status *
IQ/BQ/AUXOP/COMMODORE
Date of Birth *
MM / DD / YYYY
Enter your birthdate
Weight *
In pounds
Height *
Enter in Inches
Hair Color *
Enter hair color
Eye Color *
Enter eye color
Blood Type *
Select blood type from drop down menu
Flotilla Number *
Enter Flotilla Number (091-XX-XX)
Enter Member Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

The address you submit is the address the card will be mailed to and it must match the address listed for you in the AUXDirectory. If not, the member must change their own information in the Directory, or via their FSO-IS.
Enter email *
Please use an email that you check and use regularly
Phone Number *
### - ### - ####
Please enter a phone number that you can be reached at
Photo Upload *
JPEG Only