Georgia Trackers Alliance
Membership Application

Type of Membership       Active Member         Associate Member		Date:_____/_____/_____

Last Name:				First:			MI:		DOB:_____/_____/_____
Address:									SSN:_____-_____-_____
City:					State:		ZIP:			Height:_______ Weight:_______
Phone: Hm(_____)_____-______		Pgr(____)___-______	Hair:_________ Eyes:________
	  Wk(_____)_____-______		Cell(____)___-______	Glasses / Contacts: Y___ N ___
Email:										Allergies:
										Medications:

Tracking CLASSES	    Dates	      Certifications:  Yr/Mo 
	
					___/___/___		JHPTS	__/__	      LEVEL __________
					___/___/___		NASAR	__/__	      LEVEL __________
					___/___/___		IC		__/__	      LEVEL __________ 						___/___/___		Dog Handler	__/__ 	      SOURCE  __________
 	
Outdoor Experience: Hiking__, Backpacking__,	Personal Gear: SAR Ten Essentials: __
Climbing__, Rappelling__, Mountaineering__, 		Warm Weather__, Cold Weather__, Tech__
Survival__, Camping___, Other:_____________	Comm Equipment: CB__, HAM__, Other__	

Mission Availability: Full__, Limited__, None__	Personal Transportation:	Yr:___ Make:
If limited, specify:						Model:		Tags:
What do you expect from GTA?

Tracking Interests (all that apply)                                 Long Term Goal for Classification
  Search and Rescue		     Associate                TYPE	                     ACTIVE      TYPE
     Law Enforcement		Improve Search Skills                         	            Novice
           Man Tracking 		   Develop Awareness	   		        	    Basic	
       Animal Tracking	         Help with GTA dispatch			       Apprentice
            Recreational		            Support GTA logistics	  		     Journeyman
             			  	             			       Sign Cutter  
             			  	             			 Mission Ready?  						  
										  	
What is your current occupation:	

Are you currently volunteering with any other organizations?		YES	   NO	If yes, please list

Do you have experience in any of the following area’s:

	Computers		Public Relations		Financial		Teaching	
	Webdesign/Hosting		Media		Budget Planning		Adults	
	Word Processing		Advertising		Fundraising		Teens	
	Spreadsheets		Public Speaking		Taxes		Children	
	Data Analysis				Grant Writing		SAR	
	Graphics / Design						Tracking	

By signing this document I agree that the enclosed information is true to the best of my knowledge.
Any act to deliberately mislead or defraud GTA will be grounds for dismissal or expulsion from the organization. I release GTA and all of its members from any liability due to injury to myself or my own personal equipment whether from my own actions or the actions of others.

Signature:						Date:

Fees Paid:				Received By:				Date: