CDHAM Affiliated Staff Program |

Please fill out this form if you would like to be entered into the CDHAM database of Affiliated Staff

Last Name*
First Name*
Middle Initial
Sex
- Male
- Female
Date of Birth
Military Status
Service Branch or Employment Status
Rate / Rank
Current Duty station or employment location
Expected date of Permanent Change of Station
Commanding Officer or Supervisor
Nationality
Passport
- Yes
- No
Passport Type (if YES)
Passport date of expiration
Language
Language Proficiency
Clearance
Current Position
Work Address
Street AddressAddress Line 2CityState / Province / RegionZip / Postal CodeCountry
Home Address
Street AddressAddress Line 2CityState / Province / RegionZip / Postal CodeCountry

Military Training
SERE Level 1 Date Completed
Anti-terrorism Date Completed
Leadership / Management Training Courses
Facilitator Training Courses / Activites
Operational Qualifications
Other Courses*
Please list any other courses or training received while in the Military

International Experience
Specific area(s) of interest
Narrative*
Provide a brief narrative of any specific international and/or operational experience that you feel will be beneficial as a staff member at CDHAM
CV*
Please upload a current curriculum vita (CV)
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CDHAM Affiliated Staff Program