2025 Board of Directors - Coast Guard Mutual Assistance

Self-Nomination Form

Position You're Applying For(Required)

Active Duty Commissioned Officer (O5 & Above)

Active Duty Commissioned Officer (O1-O4)

Chief Warrant Officer (Active Duty W2-W4)

Alternate for Chief Petty Officer (Active Duty E7-E9)

Active Duty Enlisted (E4-E6)

Medical/Tricare Specialist

IT/Cyber Specialist

Commissioned Officer's Spouse

Contact Information

Your Name(Required)

First Middle Last Suffix

Rank/Rate/Grade/Title(Required)

Year Started with the Coast Guard (enlisted, commissioned, hired)

Personal Email(Required)

Personal Phone(Required)

Work Email

Work Phone

Home Address(Required)

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

Employment History/Experience

Start with the most current.

1. Title

1. Organization/Unit

1. Start Date

1. Current

2. Title

2. Organization/Unit

2. Start Date

2. End Date

3. Title

3. Organization/Unit

3. Start Date

3. End Date

4. Title

4. Organization/Unit

4. Start Date

4. End Date

5. Title

5. Organization/Unit

5. Start Date

5. End Date

Your Thoughts

What aspect of CGMA's mission holds the greatest personal significance for you?(Required)

What skills, connections, resources, and expertise are you prepared to contribute as a member of the Board of Directors for CGMA?(Required)

What attributes are essential for someone to be considered an excellent board member?(Required)

Do you have any additional information you'd like to share with the selection committee?

Phone

This field is for validation purposes and should be left unchanged.