New York State Division of Military and Naval Affairs

Governor Andrew Cuomo | Major General Raymond F. Shields Jr.

The New York Guard

Have a recruiter call me

To help us better serve you in your desire to become a part of our team, please fill out the following information. A New York Guard recruiter will contact you to help you determine how you can best serve your State and Country in the New York Guard. You are under no obligation to join.

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Contact Information

Name
Street
City	State		Zip
Home Phone	Work phone		Sex	M F
Email	DOB	/ /
Referred By

Education High School College (2yr) College (4yr) Post Graduate Degree

Degree(s)

Civilian Experience

Occupation(s)

Prior Military Experience

Army	Discharge Date:	Highest Grade:
Air Force	Discharge Date:	Highest Grade:
Marine Corps	Discharge Date:	Highest Grade:
Navy	Discharge Date:	Highest Grade:
Coast Guard	Discharge Date:	Highest Grade:

Areas of Interest (Check all that apply)

	CERFP Learn decontamination and rescue techniques. Train in the use of the equipment needed in order to respond to chemical, biological, radiological or nuclear incidents.
	MERN Develop the radio communications skills necessary to work on the Military Emergency Radio Network during communications blackouts.
	CERT Train and work in conjunction with disaster relief professionals as well as qualified civilian volunteers in order to offer aid and guidance to victims of major events.
	SAR Search and Rescue certification for working with State Agencies in the fields.
	Engineering Construction professionals can put their skills and experience to work on military bases as well as the field during emergencies.
	JAG / MEDICAL Legal and Medical professionals can provide assistance to the National Guard as they prepare for Deployment, as well as in the field during emergencies.
	Headquarters / Administration.
	New York Guard Band

Your Message

Feel free to tell us about yourself and why you would like to join the New York Guard.

Submitting the information requested above does not imply a commitment or obligation to enlist in the New York Guard. All information supplied is regarded as confidential, accepted for preliminary evaluation purposes only and will not be disclosed to third parties.

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