Form 17 Application PDF Details

The 17 Application Form, vital within the framework of senior member activities, encompasses a broad spectrum of information crucial for the participation and recognition within the Civil Air Patrol (CAP). This optional form, adhering to the guidelines set forth in CAPR 50-17, is a comprehensive document designed to facilitate the application process for a variety of activities, positions, and professional development opportunities. It meticulously collects personal data, CAP membership details, including grade and ID, as well as educational achievements and professional backgrounds of applicants. Furthermore, it delves into specifics such as activity titles, locations, and participation history, alongside required medical information and personal goals within the CAP. The form also lays out a structured pathway for approval, necessitating endorsements from unit to regional commanders, thereby ensuring a layered review process. As such, the form not only serves as a means of applying for activities but also as a record of an individual’s commitment, achievements, and aspirations within the Civil Air Patrol, marking avenues for their development and recognition within this esteemed organization.

QuestionAnswer
Form NameForm 17 Application
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other namescap application activities, capf 17 fillable, senior member activities printable, cap form 17

Form Preview Example

APPLICATION FOR SENIOR MEMBER ACTIVITIES

Note: Use of this form is optional (see CAPR 50-17, para 2-7b2). See instructions on reverse.

1.

 

 

Title of Activity (If applying for a position, include the position desired)

2.

Location of Activity

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

3.

 

 

Dates of Activity

 

 

 

 

4. Previously Attended This Activity?

 

 

 

 

 

 

 

 

 

 

 

 

 

No

Yes (if yes, give date)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

5.

 

 

Last Name, First, Middle Initial

 

 

 

 

 

 

 

6.

CAP Grade

 

7. CAPID

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

8.

 

 

Member’s Address (Include No., Street, City, State, Zip)

9. Telephone (Include Area Code)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Work (

 

)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Home (

 

)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

E-Mail

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

10. Charter Number

11. Unit Name

 

 

 

 

 

 

 

12. Date of Level I Completion

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

13. Date Joined CAP

14. CAP Duty Assignment and Inclusive Dates

 

15. CAP Aeronautical Rating

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

16. Specialties and Ratings Completed

 

 

 

 

17. Previous Training Activities and Years Attended

 

 

Specialty

 

 

Rating

 

 

 

 

a.

 

 

 

 

 

 

 

 

 

 

a.

 

 

 

 

 

 

 

 

 

b.

 

 

 

 

 

 

 

 

 

 

b.

 

 

 

 

 

 

 

 

 

c.

 

 

 

 

 

 

 

 

 

 

c.

 

 

 

 

 

 

 

 

 

d.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

d.

 

 

 

 

 

 

 

 

 

e.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

18. Professional Development Awards

 

 

 

 

19. Scholastic Achievement

 

 

 

 

 

a.

 

 

 

 

 

 

 

 

 

 

High School Graduate (Year):

 

 

 

 

 

b.

 

 

 

 

 

 

 

 

 

College (Number of Years):

 

 

 

 

 

c.

 

 

 

 

 

 

 

 

 

 

Post Graduate (Number of Years):

 

 

d.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

20. Civilian Occupation

21. Emergency Medical Information

22.

Outline Personal and Professional Goals in CAP

 

 

 

 

 

23.

Remarks (Use Reverse Side or Attach Additional Sheet if Necessary)

Applicant’s Signature and Date

 

 

 

 

24.

Unit Commander (if required)

 

Unit Commander’s Signature and Date

Recommend

Approval

 

Disapproval

 

 

Remarks:

 

 

 

 

 

 

 

 

 

25.

Wing Commander (if required)

 

Wing Commander’s Signature and Date

Recommend

Approval

 

Disapproval

 

 

Remarks:

 

 

 

 

 

 

 

 

 

26.

Region Commander (if required)

 

Region Commander’s Signature and Date

 

Region

Selection Number

 

 

 

Recommend

Approval

 

Disapproval

 

 

Remarks:

 

 

 

 

 

 

 

 

 

CAP FORM 17, JUL 09

PREVIOUS EDITIONS WILL NOT BE USED AFTER 31 AUG 09

OPR/ROUTING: PD

27. Additional Remarks:

INSTRUCTION FOR COMPLETION OF CAP FORM 17

NOTE: Use of this form is optional at the discretion of the activity director (see CAPR 50-17, para 2-7b2).

See CAPR 50-17, CAP Senior Member Professional Development Program, for additional information and instructions.

1.APPLYING FOR ACTIVITIES:

a.For region level activities, unit commander verifies the information, makes recommendation, signs the application, retains a copy, and forwards the original to wing headquarters. Wing commander verifies application, makes recommendation, signs the application, retains a copy, and forwards the original to region headquarters for final approval by region commander.

b.For selected national level activities, unit commander verifies the information, makes recommendation, signs the application, retains a copy, and forwards the original to wing headquarters. Wing commander verifies application, makes recommendation, signs the application, retains a copy, and forwards the original to region headquarters for action (if applicable). Region commander makes recommendation, assigns selection number, signs the application, retains a copy, and forwards original to NHQ CAP/PD.

2.COMPLETING THE FORM:

Blocks 1-11, 13-15, 19-20 are self explanatory.

Block 12. Enter the month and year of Level I completion. (Example: Feb 92)

Block 16. List each specialty and the highest rating completed in that specialty. (Example: Enter 213-2 for Emergency Services Officer - Senior Level, or enter 201-1 for Public Affairs - Technician Level.)

Block 17. List names and dates of training activities such as SAR exercises, SLS, AFIADL Course-13, RSC, ACSC, AWC, etc. Use Additional Remarks section above or add additional sheet if necessary.

Block 18. List training awards only along with completion dates. (Example: Garber Award Aug 90.)

Block 21. List physical handicaps or ailments for which the applicant will be taking medication during the activity or which might affect the applicant’s level of participation in activities. Provide a list of medication taken regularly. Use Additional Remarks section or add additional sheet if necessary.

Block 24. For Unit Commander.

Remarks are intended for consideration by the wing commander. Use Additional Remarks section or add additional sheet if necessary.

Block 25. For Wing Commander.

For National Staff College (NSC), wing commander approves for personnel assigned within their wing, then forwards to NHQ CAP/ETP. Use Additional Remarks section or add additional sheet if necessary.

Block 26. For Region Commander.

For National Staff College (NSC), this block is completed by region commander only for those members currently serving on the region staff, and then forwarded to NHQ CAP/PD. Remarks are intended for consideration by National Headquarters. Use Additional Remarks section or add additional sheet if necessary.

CAP FORM 17, JUL 09

REVERSE

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2. After this part is done, you're ready to add the essential details in Professional Development Awards, Scholastic Achievement, Civilian Occupation, Outline Personal and Professional, High School Graduate Year, College Number of Years, Post Graduate Number of Years, Emergency Medical Information, Remarks Use Reverse Side or, Applicants Signature and Date, Unit Commander if required, Unit Commanders Signature and Date, Recommend, Approval, and Disapproval so that you can go to the 3rd step.

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3. The following step is focused on Additional Remarks, INSTRUCTION FOR COMPLETION OF CAP, NOTE Use of this form is optional, See CAPR CAP Senior Member, a For region level activities unit, signs the application retains a, b For selected national level, and recommendation signs the - fill in these blank fields.

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