U. S. Coast Guard Auxiliary bar

Division 5 Auxiliary members:  use this form to report or modify scheduled Vessel Safety Checks

City where VSC is scheduled:

Date, time and location (marina, ramp, etc. where VSC will be conducted):
    

Name of Auxiliary contact: 
Telephone number:                             
E-mail address:                                   

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Person submitting information (name, Flotilla and telephone number are required fields)

Name         Telephone No
Flotilla                                                                         E-mail address
  

Comments:

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