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Username
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Spaces are allowed; punctuation is not allowed except for periods, hyphens, apostrophes, and underscores.
E-mail address
*
A valid e-mail address. All e-mails from the system will be sent to this address. The e-mail address is not made public and will only be used if you wish to receive a new password or wish to receive certain news or notifications by e-mail.
Volunteer Profile
Multipage
Demographics
Name
*
First
Last
Please enter your name or the name your prefer to be called by.
Full Legal Name
*
Title
--
Capt.
Dr.
Miss
Mr.
Mrs.
Ms.
Prof.
First
Middle
Last
Suffix
--
Jr.
Sr.
I
II
III
IV
V
VI
VII
VIII
IX
X
Please enter your full legal name.
Date of Birth
E.g., 06/20/2013
Please enter your birthday. Use the following format: mm/dd/yyyyy or use the calendar to select your birthday (make sure you choose the right year!)
Gender
*
Male
Female
Profession
1
/
5
Contact Information
Phone Number:
*
Order
*
Weight for row 1
0
Please entry the best phone number at which you can be contacted. You can also enter additional numbers.
Mailing Address
Please enter your mailing address.
Address 1
*
Address 2
City
*
State
*
--
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District Of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
--
American Samoa
Federated States of Micronesia
Guam
Marshall Islands
Northern Mariana Islands
Palau
Puerto Rico
Virgin Islands
ZIP Code
*
2
/
5
Emergency / Medical Information
Emergency Contact:
Order
Name
First
Last
Relationship
How are you related to this emergency contact?
Phone:
Order
Weight for row 1
0
Please enter one or more phone numbers for this emergency contact.
Address
Country
United States
Address 1
Address 2
City
State
--
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District Of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
--
American Samoa
Federated States of Micronesia
Guam
Marshall Islands
Northern Mariana Islands
Palau
Puerto Rico
Virgin Islands
ZIP Code
Weight for row 1
-1
0
1
Name
First
Last
Relationship
How are you related to this emergency contact?
Phone:
Order
Weight for row 1
0
Please enter one or more phone numbers for this emergency contact.
Address
Country
United States
Address 1
Address 2
City
State
--
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District Of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
--
American Samoa
Federated States of Micronesia
Guam
Marshall Islands
Northern Mariana Islands
Palau
Puerto Rico
Virgin Islands
ZIP Code
Weight for row 2
-1
0
1
Medical Insurance Carrier
Insurance Policy Number
Physician
Title
Dr.
First
Middle Initial
Last
Physician Phone Number
Allergies / Special Conditions
3
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5
About
Biography
A short biography about who you are. The biography will be viewable by other users and displayed on the public crew list page.
Medical Training
Please describe any medical training or background you may have. If you hold any medical training certificates, please indicate them below.
Medical Training Certifications:
Order
Medical Training Certification Type
- None -
CPR/AED
First Aid
Other
Please indicate which medical training or certification you hold. If you have a certification other than CPR/AED or First Aid, please select "Other."
Other Medical Training Certification Type
Please indicate your medical training or certification type.
Certification Expiration Date
Month
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Year
2010
2011
2012
2013
2014
2015
2016
Please indicate the date on which this certification expires.
Weight for row 1
-1
0
1
Medical Training Certification Type
- None -
CPR/AED
First Aid
Other
Please indicate which medical training or certification you hold. If you have a certification other than CPR/AED or First Aid, please select "Other."
Other Medical Training Certification Type
Please indicate your medical training or certification type.
Certification Expiration Date
Month
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Year
2010
2011
2012
2013
2014
2015
2016
Please indicate the date on which this certification expires.
Weight for row 2
-1
0
1
Please indicate any medical training or certifications you currently hold.
How did you hear about Spirit of the Sea
Tell us how you found out about Spirit of the Sea
4
/
5
Background Check
Have you ever been convicted of a felony?
*
Yes
No
Please indicate whether you have ever been convicted of a felony. Answering "Yes" does not necessarily disqualify you from volunteering with Spirit of the Sea.
If so, please explain:
Please provide an explanation and details on your felony conviction.
References:
Order
Reference Name
First
Last
Relationship
Your relationship to this reference.
Phone
The reference\'s phone number
Email
The reference\'s email address.
Weight for row 1
-1
0
1
Reference Name
First
Last
Relationship
Your relationship to this reference.
Phone
The reference\'s phone number
Email
The reference\'s email address.
Weight for row 2
-1
0
1
5
/
5
Terms and Conditions of Use
I affirm that the information I have supplied in my crew/user application and elsewhere on this site is complete and accurate. I give my permission for Spirit of the Sea to use this information to perform a background check and to contact my references.
Accept
Terms & Conditions of Use
*