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FOR RIGGERS
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USAPR RESERVATION APPLICATION FORM
Last Name:
First Name:
Address:
City:
State:
Zip code:
Daytime Phone:
Occupation:
email address:
Number of Jumps:
Date of Last Jump:
Do you hold a FAA Rigger Certificate?
(Candidates for Added Rating, please complete this section)
Senior
Master
Seal Symbol:
Certificate Number:
Year:
RATINGS HELD:
Check appropriates boxes:
Back
Chest
Seat
Military Rigger Military Unit:
SELECT COURSE TYPE:
Senior
Master
Para-Flite
RI POC
ASC/AR
Military NSE
Insert Number of pack jobs log:
RESERVE PACKS:
Reserve Back-Square:
Reserve Chest-Square:
Reserve Back-Round:
Reserve Chest-Round:
Reserve Seat-Round:
MAIN PACKS:
Main Square:
Main Round:
Military Rigger without Logbook:
BRIEFLY DESCRIBE RIGGING BACKGROUND:
Include packing, sewing, repair or manufacturing experience including your goals.
Proposed course date:
T-Shirt Size:
X-Large
Large
Medium
Application Date: