To be completed by commander or designated representative: I certify that the applicant has been introduced to the Core
Values, Ethics Policies, and Safety Policies, and that I have fully reviewed the OATH OF MEMBERSHIP (on reverse) with the
potential new member. I further certify that a mentor has been assigned to assist this member in their orientation and
training. Membership becomes effective when this application is approved and processed by National Headquarters.
Charter, Unit Name and Address
Print Commander's Full Name Commander's Signature Date
To help us better serve our members, please tell us how you heard about Civil Air Patrol (check all that apply):
Air Show CAP Exhibit CAP Member Friend Radio Magazine Television
Family Member CAP Website CAP Volunteer Magazine Other (please name):
Voluntary Statistical Information (For Demographic Research Only -- Not Required For Membership)
Identification: White Afro-American Hispanic Asian Pacific Islander
American Indian Alaskan Native
What CAP Activities Are You Most Interested In?
AEROSPACE EDUCATION PROGRAM CADET PROGRAM EMERGENCY SERVICES
AEROSPACE EDUCATION OFFICER DRILL AND CEREMONIES CHECK PILOT
AEROSPACE EDUCATION INSTRUCTOR DRIVER COUNTERDRUG PILOT
CADET AEROSPACE OPPORTUNITIES ENCAMPMENT STAFF DISASTER RELIEF
COUNSELOR
FLIGHT ENCAMPMENT STAFF INSTRUCTOR PILOT
SPEAKER INSTRUCTOR SEARCH AND RESCUE
LEADERSHIP POSITION GROUND TEAM
ORIENTATION PILOT PILOT
SPECIAL ACTIVITIES STAFF OBSERVER/SCANNER
RADIO COMMUNICATIONS
Please List Any Other Skills Or Interests You Have Which Might Be Helpful To Your CAP Unit:
OATH OF MEMBERSHIP
(READ CAREFULLY BEFORE SIGNING)
I do solemnly swear (or affirm) that:
I understand membership in the Civil Air Patrol is a privilege, not a right, and that membership is on a year-to-year basis
subject to recurring renewal by CAP. I further understand failure to meet membership eligibility criteria will result in automatic
termination at any time.
I voluntarily subscribe to the objectives and purposes of the Civil Air Patrol and agree to be guided by CAP Core Values,
Ethics Policies, Constitution & Bylaws, Regulations and all applicable Federal, State, and Local Laws.
I understand only the Civil Air Patrol corporate officers are authorized to obligate funds, equipment, or services.
I understand the Civil Air Patrol is not liable for loss or damage to my personal property when operated for or by the Civil Air
Patrol. I further understand that safety is critical for the protection of all members and protection of CAP resources. I will at all
times follow safe practices and take an active role in safety for myself and others.
I agree to abide by the decisions of those in authority of the Civil Air Patrol.
I certify that all information on this application is presently correct and any false statement may be cause to deny membership. I
understand I am obligated to notify the Civil Air Patrol if there are any changes pertaining to the information on the front of this
form and further understand that failure to report such changes may be grounds for membership termination.
I fully understand that this Oath of Membership is an integral part of this application for senior membership in the Civil Air
Patrol and that my signature on the form constitutes evidence of that understanding and agreement to comply with all contents
of this Oath of Membership.
Signature of Applicant: Date:
Witness Signature: Date:
Mail completed application package to: National Headquarters
, Civil Air Patrol, ATTN: Membership Services, 105
South Hansell Street, Maxwell AFB AL 36112. Checks should be made payable to: National Headquarters Civil Air
Patrol.
CAP FORM 12, FEB 14 REVERSE
CAP Commander or Designated Representative
