Engineer Badge – Application Form
Engineer Badge – Application Form
SGAUS membership required. Incomplete applications will not be processed.
Date
Name
*
Name
First Name
First Name
Last Name
Last Name
Middle Initial
Personal Email
*
IE: joe.snuffy@gmail.com
Official Email
*
IE: joe.snuffy@army.mil | joe.snuffy@zulustateguard.gov
Rank
*
Spelled out – IE: Staff Sergeant (Do not include numbers, state, US, etc)
Service
Spelled out – IE: Air Force, Air National Guard, Zulu Defense Force. If not in a service: Leave Blank
Address
*
Address
Address
Address
City
City
State/Province
Alabama
Alaska
Arkansas
Arizona
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
State/Province
Zip/Postal
Zip/Postal
Phone
*
I am a SGAUS Member
*
Yes
No
Military/Civilian Resume
*
Drop a file here or click to upload
Choose File
Maximum file size: 5MB
PDF Only
Requested Badge Level
*
Basic Engineer Qualification
Senior Engineer Qualification
Certificate Upload – SGAUS Basic Engineer Qualification
*
Drop a file here or click to upload
Choose File
Maximum file size: 5MB
American Red Cross, AHA, or Equivalent
First Aid
*
Drop a file here or click to upload
Choose File
Maximum file size: 5MB
American Red Cross, AHA, or Equivalent
Certificate Upload – CPR — American Heart Assoc. (or equivalent/Red Cross)
*
Drop a file here or click to upload
Choose File
Maximum file size: 5MB
Official Certification Certificate as issued from certification vendor
Certificate Upload – Jobsite Safety – – OSHA 30-Hour (or USACE EM 385.1.1)
*
Drop a file here or click to upload
Choose File
Maximum file size: 5MB
Official Certification Certificate as issued from certification vendor
Certificate Upload – Land Nav
*
Drop a file here or click to upload
Choose File
Maximum file size: 5MB
Official Certification Certificate as issued from certification vendor
Certificate Upload – Radio Procedure Training (Minimum 4-Hours)
*
Drop a file here or click to upload
Choose File
Maximum file size: 5MB
Official Certification Certificate as issued from certification vendor
Certificate Upload – Army Field Sanitation (or equivalent 4-hour course)
*
Drop a file here or click to upload
Choose File
Maximum file size: 5MB
Certificate Upload – Engineer Position Task Book (PTB)
*
Drop a file here or click to upload
Choose File
Maximum file size: 5MB
Official Certification Certificate as issued from certification vendor
Certificate Upload – Certificate of Completion from a HazMat Awareness course (e.g., FEMA, TEEX, CDP, or an organizational training program)
*
Drop a file here or click to upload
Choose File
Maximum file size: 5MB
Official Certification Certificate as issued from certification vendor
Certificate Upload – IS-242.b: Effective Communication
*
Drop a file here or click to upload
Choose File
Maximum file size: 5MB
Certificate Upload – Bloodborne Pathogens – Certificate of Training
*
Drop a file here or click to upload
Choose File
Maximum file size: 5MB
Official Certification Certificate as issued from certification vendor
Certificate Upload – IS-368: Access and Functional Needs in Disaster Operations
*
Drop a file here or click to upload
Choose File
Maximum file size: 5MB
Official Certification Certificate as issued from certification vendor
Certificate Upload – Psychological First Aid course (Red Cross or equivalent)
*
Drop a file here or click to upload
Choose File
Maximum file size: 5MB
Official Certification Certificate as issued from certification vendor
Certificate Upload – Active legal authority (state / territorial license) as an MD/DO, NP, or PA
*
Drop a file here or click to upload
Choose File
Maximum file size: 5MB
Official Certification Certificate as issued from certification vendor
Certificate Upload – Current DEA Registration
*
Drop a file here or click to upload
Choose File
Maximum file size: 5MB
Official Certification Certificate as issued from certification vendor
Certificate Upload – MEMS (SGAUS Military Emergency Management) Basic Certification
*
Drop a file here or click to upload
Choose File
Maximum file size: 5MB
Official Certification Certificate as issued from certification vendor
Certificate Upload – Bachelor’s in engineering, architecture, or technical trade license/certification
*
Drop a file here or click to upload
Choose File
Maximum file size: 5MB
Official Certification Certificate as issued from certification vendor
Certificate Upload – IS-163 Hazard Mitigation Grants
*
Drop a file here or click to upload
Choose File
Maximum file size: 5MB
Official Certification Certificate as issued from certification vendor
Certificate Upload – IS-164 HM Hazards & Performance Analysis
*
Drop a file here or click to upload
Choose File
Maximum file size: 5MB
Official Certification Certificate as issued from certification vendor
Certificate Upload – IS-276 Benefit-Cost Analysis Fundamentals
*
Drop a file here or click to upload
Choose File
Maximum file size: 5MB
Official Certification Certificate as issued from certification vendor
Certificate Upload – IS-393 Intro to Hazard Mitigation
*
Drop a file here or click to upload
Choose File
Maximum file size: 5MB
Official Certification Certificate as issued from certification vendor
Certificate Upload – IS-634 Public Assistance Program
*
Drop a file here or click to upload
Choose File
Maximum file size: 5MB
Official Certification Certificate as issued from certification vendor
Certificate Upload – IS-922 GIS for Emergency Mgmt
*
Drop a file here or click to upload
Choose File
Maximum file size: 5MB
Official Certification Certificate as issued from certification vendor
Certificate Upload – IS-2700 National Mitigation Framework
*
Drop a file here or click to upload
Choose File
Maximum file size: 5MB
Official Certification Certificate as issued from certification vendor
Certificate Upload – IS-2900 National Disaster Recovery
*
Drop a file here or click to upload
Choose File
Maximum file size: 5MB
Official Certification Certificate as issued from certification vendor
Certificate Upload – E/L0313 Basic Hazus (Classroom)
*
Drop a file here or click to upload
Choose File
Maximum file size: 5MB
Official Certification Certificate as issued from certification vendor
Certificate Upload – IS-240.b: Leadership & Influence
*
Drop a file here or click to upload
Choose File
Maximum file size: 5MB
Official Certification Certificate as issued from certification vendor
Certificate Upload – Operational Risk Management: TEEX AWR-401
*
Drop a file here or click to upload
Choose File
Maximum file size: 5MB
Official Certification Certificate as issued from certification vendor
Blue Flash
*
Yes, requesting
No, not requesting
Blue Flash – Documentation (Orders or Awards) demonstrating past activation specifically within this specialty
Drop a file here or click to upload
Choose File
Maximum file size: 5MB
Submit
If you are human, leave this field blank.