HOME CONTACT REGISTRY CERTIFICATE APPLICATION



USADR APPLICATION

NAME:                                                                               DATE:

ADDRESS:                                                                       EMAIL:

 

DOB:

DISCIPLINE:                                                                    CURRENT RANK:

 

CHECK BOX IF REGISTERING CURRENT RANK []

CHECK BOX IF APPLYING UPGRADE RANKING [] 

ATTACH COPY CURRENT RANK CERTIFICATION []  *USADR members forward cert# and issue date for records CK. 

****MAKE APPROPRIATE FEE PAYMENT(S) WITH U.S. MONEY ORDER ADDRESSED TO USADR****

NO PERSONAL CHECKS 

 

****PRINT PAGE FOR APPLICATION PROCESS****