entry - level mmd w i z a r d u. s. coast guard mariner licensing & documentation entry-level...

EEntry - ntry - LLevel MMD evel MMD WW i i z a r dz a r d

U. S. Coast GuardU. S. Coast Guard

Mariner Licensing & DocumentationMariner Licensing & Documentation

Entry-Level MMD Wizard was designed to assist mariners and licensing professionals with making application for an Entry Level Merchant Mariners Document (MMD).

This Wizard does not assist with the issuance or renewal of the Transportation Worker Identification Credential (TWIC).

The Transportation Security Administration (TSA) is the responsible agency for the issuance and renewal of the TWIC. Please access www.tsa.gov/twic for the latest info regarding the TWIC.

http://www.tsa.gov/twic

You can also use the menus to navigate, similar to web page navigation. Click on the topic you want to display or review.

Simply click to advance through the slide presentation, or

Getting StartedGetting Started

Sub menus will appear when necessary.

Main Menu

Getting Started

Application

Fees

Citizenship and Nationality

Identity

Fingerprints

Passport Photos

Certification of Fitness

Drug Test

Checklist

Getting Started Sub-Menu

Instructions

Disclaimer

Overview

References

Where to Apply

List of RECs (A-M)

List of RECs (N-Z)

Forms & Reference

Web Links

About

Instructions...Instructions...

Applicable law supersedes all information contained herein…


Main Menu

Getting Started

Application

Fees


Identity

Fingerprints

Passport Photos


Drug Test

Checklist


Instructions

Disclaimer

Overview

References

Where to Apply

List of RECs (A-M)

List of RECs (N-Z)

Forms & Reference

Web Links

About

Disclaimer...Disclaimer...


Main Menu

Getting Started

Application

Fees


Identity

Fingerprints

Passport Photos


Drug Test

Checklist


Instructions

Disclaimer

Overview

References

Where to Apply

List of RECs (A-M)

List of RECs (N-Z)

Forms & Reference

Web Links

About

USCG Credential IssuedUSCG Credential Issued

Complete & Accurate Application

Proper User Fees

Original Proof of Citizenship or Nationality

2 Passport Photos & Camera Set-up Form

Complete & Accurate Certification of Fitness

Acceptable (negative) Drug Test

Original Proof of Identity & SSN

Safety & Security Background Clearance

Fingerprinted by REC PersonnelReturn to Applicant

Overview...Overview...


46 United States Code Annotated (U.S.C.A.), Title 46—Shipping.

Code of Federal Regulations (CFR), Title 46, Parts 1 to 40—Shipping.

Marine Safety Manual (MSM), Volume III, Marine Industry Personnel, COMDTINST M16000.8 (Series).

Applicable Navigation and Vessel Inspection Circulars (NVICs).

Applicable USCG Policy Letters & Guidance Documents.

Main Menu

Getting Started

Application

Fees


Identity

Fingerprints

Passport Photos


Drug Test

Checklist


Instructions

Disclaimer

Overview

References

Where to Apply

List of RECs (A-M)

List of RECs (N-Z)

Forms & Reference

Web Links

About

References...References...


You may apply in person at any Regional Examination Center (REC).

Main Menu

Getting Started

Application

Fees


Identity

Fingerprints

Passport Photos


Drug Test

Checklist


Instructions

Disclaimer

Overview

References

Where to Apply

List of RECs (A-M)

List of RECs (N-Z)

Forms & Reference

Web Links

About

Where to Apply...Where to Apply...

AnchorageUSCG REC Anchorage

800 E. Diamond Blvd, Suite 3-227

Anchorage, AK 99515(907) 271-6736

(907) 271-6742 (Fax)[email protected]

Guam (Monitoring Unit)USCG REC GuamPSC 455, Box 176

FPO AP, Guam 96570-1056(671) 339-2001, Ext 153


Ketchikan (Monitoring Unit)USCG REC Ketchikan

1621 Tongass Avenue, Suite 202

Ketchikan, AK 99901(907) 225-4496


BaltimoreUSCG REC Baltimore

40 South Gay Street, Room 420Baltimore, MD 21202-4022

(410) 962-5132/5147(410) 962-0930 (Fax)

HonoluluUSCG REC Honolulu433 Ala Moana Blvd

Honolulu, HI 96813-4909(808) 522-8264

(808) 522-8277 (Fax)

Long BeachUSCG REC Long Beach

501 West Ocean Blvd, Suite 6200

Long Beach, CA 90802(562) 495-1480

(562) 435-1050 (Fax)

BostonUSCG REC Boston

455 Commercial StreetBoston, MA 02109-1045

(617) 223-3040(617) 223-3034 (Fax)

HoustonUSCG REC Houston

8876 Gulf Freeway, Suite 200Houston, TX 77017-6595

(713) 948-3350(713) 948-3360 (Fax)

[email protected]@uscg.mil

MemphisUSCG REC Memphis

200 Jefferson Avenue, Suite 1302

Memphis, TN 38103-2300(901) 544-3297

(866) 777-2784 (Toll Free)(901) 544-3372 (Fax)

CharlestonUSCG REC Charleston

196 Tradd StreetCharleston, SC 29401-1800

(843) 720-3250(800) 826-1511 (Toll Free)

(843) 720-3259 (Fax)

JuneauUSCG REC Juneau

2760 Sherwood Lane, Suite 2AJuneau, AK 99801-8545

(907) 463-2458(907) 463-2445 (Fax)

[email protected]

MiamiUSCG REC Miami

Claude Pepper Federal Building51 S.W. 1st Avenue, 6th Floor

Miami, FL 33130-1608(305) 536-6548/6549/6874(800) 982-9374 (Toll Free)

(800) 536-4304 (Fax)


Main Menu

Getting Started

Application

Fees


Identity

Fingerprints

Passport Photos


Drug Test

Checklist


Instructions

Disclaimer

Overview

References

Where to Apply

List of RECs (A-M)

List of RECs (N-Z)

Forms & Reference

Web Links

About

List of RECs (A-M)...List of RECs (A-M)...

mailto:[email protected]

New OrleansUSCG REC New Orleans

4250 Highway 22, Suite FMandeville, LA 70471

(985) 624-5700(985) 624-5757 (Fax)

San Francisco BayUSCG REC San Francisco BayOakland Federal Bldg, North

Tower1301 Clay Street, Room 180N

Oakland, CA 94612-5200(510) 637-1124


ToledoUSCG REC Toledo

420 Madison Ave, Suite 700Toledo, OH 43604

(419) 418-6010(419) 259-7558 (Fax)

New YorkUSCG REC New YorkBattery Park Building

1 South StreetNew York, NY 10004-1466

(212) 668-7492(212) 668-6394 (Fax)

San Juan (Monitoring Unit)USCG REC San Juan5 Calle La Puntilla

San Juan, PR 00901(787) 729-2376

(787) 729-2364 (Fax)

National Maritime Center Detachment

150 East Burr Blvd, Top FloorKearneysville, WV 25430

(304) 728-9100(304) 728-7373 / 7332 (Fax)

Puget Sound (Seattle)USCG REC Seattle

Jackson Federal Building915 Second Ave, Room 194

Seattle, WA 98174-1067(206) 220-7327

(206) 220-7329 (Fax)

PortlandUSCG REC Portland

6767 North Basin AvenuePortland, OR 97217-3992

(503) 240-9346(503) 240-9345 (Fax)

St. LouisUSCG REC St. Louis

1222 Spruce Street, Suite 8.104E

St. Louis, MO 63103-2835(314) 539-3091

(314) 539-2659 (Fax)

Getting StartingGetting Starting

Main Menu

Getting Started

Application

Fees


Identity

Fingerprints

Passport Photos


Drug Test

Checklist


Instructions

Disclaimer

Overview

References

Where to Apply

List of RECs (A-M)

List of RECs (N-Z)

Forms & Reference

Web Links

About

List of RECs (N-Z)...List of RECs (N-Z)...




Forms & Reference Number

Application CG-719B (Rev 03/04)

Physical CG-719K (Rev 03/04)

Fitness Cert. for Entry Level Ratings CG-719K/E (Rev 03/04)

Drug Test CG-719P (Rev 03/04)

Acceptable ID MLD-FM-REC-105 (03)

MID Scanner Image Form FM-REC-102 (01)

Credit Card Authorization MLD-FM-REC-100 (01)

Drug Policy NMC GD 03-04

Drug Test Instructions FM-REC-101 (01)

Physical Standards NVIC 02-98

Sample Statement of Convictions N/A

Mariner Survey FM-REC-08 (02)

Main Menu

Getting Started

Application

Fees


Identity

Fingerprints

Passport Photos


Drug Test

Checklist


Instructions

Disclaimer

Overview

References

Where to Apply

List of RECs (A-M)

List of RECs (N-Z)

Forms & Reference

Web Links

About

Forms and Reference...Forms and Reference...


Web Link Description

http://www.uscg.mil/stcw/home.htm USCG Licensing Website

http://www.gpoaccess.gov/uscode/index.html USCA Online

http://www.gpoaccess.gov/cfr/index.html CFR Online

http://www.uscg.mil/hq/g-m/nmc/pubs/msm/vol3.htm Marine Safety Manual (MSM), Vol III

http://www.uscg.mil/hq/g-m/nvic/index90.htm NVICs

http://www.uscg.mil/STCW/mmic-policy.htm NMC Policy & Guidance

http://www.uscg.mil/hq/g-m/nmc/web/ NMCs Website

http://www.uscg.mil/STCW/mmic-appcourses.htm Approved Courses

http://workplace.samhsa.gov/DrugTesting/Level_1_Pages/CertifiedLabs.aspx

SAMHSA Drug Lab List

www.uscg.mil/hq/g-m/moa/dapip.htm Drug Service Agents

https://www.pay.gov/paygov Pay User Fees Online

Main Menu

Getting Started

Application

Fees


Identity

Fingerprints

Passport Photos


Drug Test

Checklist


Instructions

Disclaimer

Overview

References

Where to Apply

List of RECs (A-M)

List of RECs (N-Z)

Forms & Reference

Web Links

About

Web Links...Web Links...

http://www.uscg.mil/stcw/home.htm

http://www.gpoaccess.gov/uscode/index.html

http://www.gpoaccess.gov/cfr/index.html

http://www.uscg.mil/hq/g-m/nmc/pubs/msm/vol3.htm

http://www.uscg.mil/hq/g-m/nvic/index90.htm

http://www.uscg.mil/STCW/mmic-policy.htm

http://www.uscg.mil/hq/g-m/nmc/web/

http://www.uscg.mil/hq/g-m/nmc/web/

http://www.uscg.mil/STCW/mmic-appcourses.htm



http://www.uscg.mil/hq/g-m/moa/dapip.htm

https://www.pay.gov/paygov


This Wizard was designed for mariners and licensing professionals as an interactive step-by-step instructional tool for entry-level MMD credentials.

Entry-Level MMD Wizard, Version 1.1 (09/13/2007).

Entry-Level MMD Wizard can be burned on CDs and downloaded via the world wide web.

Main Menu

Getting Started

Application

Fees


Identity

Fingerprints

Passport Photos


Drug Test

Checklist


Instructions

Disclaimer

Overview

References

Where to Apply

List of RECs (A-M)

List of RECs (N-Z)

Forms & Reference

Web Links

About

About...About...

ApplicationApplication

Incomplete and inaccurate information reported on the application will cause significant delays.

False statements are grounds for denial of the application as well as criminal prosecution & financial penalty.

An approved application is valid for 12 months.

All transactions require an original application.

Use the sub-menu link to view or print the application and other documents.

Main Menu

Getting Started

Application

Fees


Identity

Fingerprints

Passport Photos


Drug Test

Checklist

Application Sub-Menu

General

Section I

Section II

Section III

Section IV

Section V

Section VI

Sections VII through IX

View / Print Application Form

View / Print Sample Statement

General...General...

This section contains important personal data. Fill in each block, or write N/A for not applicable.


By law, the next of kin information is required.

When your credential is issued by mail, the address in this section is used. Please make sure it is accurate and report changes immediately.

If you are under 18, check here & provide a notarized statement of parental or guardian consent.

Main Menu

Getting Started

Application

Fees


Identity

Fingerprints

Passport Photos


Drug Test

Checklist


General

Section I

Section II

Section III

Section IV

Section V

Section VI




Section I...Section I...


Place check marks for an Original Merchant Mariner’s Document (MMD).

In the applying for box, write or type “Entry-Level MMD”.

Write or type “N/A” in the Current or Previous License or MMD section.

Main Menu

Getting Started

Application

Fees


Identity

Fingerprints

Passport Photos


Drug Test

Checklist


General

Section I

Section II

Section III

Section IV

Section V

Section VI




Section II...Section II...

Entry-Level MMD.

N/A N/A N/A


Conviction means found guilty (felony or misdemeanor) by judgment or by plea and includes cases of deferred adjudication (no contest, adjudication withheld, etc.) OR where the court required you to attend classes, make contribution of time or money, receive treatment, submit to any manner of probation or supervision, or forgo appeal of a trial court finding. Expunged convictions must be reported unless the expungement was based upon a showing that the court’s earlier conviction was in error.

Page 1 of 3

Main Menu

Getting Started

Application

Fees


Identity

Fingerprints

Passport Photos


Drug Test

Checklist


General

Section I

Section II

Section III

Section IV

Section V

Section VI




Section III (1 of 3)...Section III (1 of 3)...


Attach a statement for all areas marked yes.

““On January 1, 2000, I was arrested for DUI . On February 5, 2000, I plead guilty to DUI On January 1, 2000, I was arrested for DUI . On February 5, 2000, I plead guilty to DUI in League City, TX. My license was suspended for 6 months, I paid a $2,000 fine, and I in League City, TX. My license was suspended for 6 months, I paid a $2,000 fine, and I attended a defensive driving course. On June 16, 2000, I completed all court requirements attended a defensive driving course. On June 16, 2000, I completed all court requirements and my DL was reinstated. I apologize for my actions and request favorable consideration and my DL was reinstated. I apologize for my actions and request favorable consideration on my application. I no longer drink and drive” on my application. I no longer drink and drive”

At a minimum, the statement must include, when, where & what happened. The statement must be signed and dated.

Page 2 of 3

Main Menu

Getting Started

Application

Fees


Identity

Fingerprints

Passport Photos


Drug Test

Checklist


General

Section I

Section II

Section III

Section IV

Section V

Section VI






The 7 questions in this section start with “Have you ever…” Therefore, regardless of how long ago a conviction occurred, it must be reported each time an application is submitted.

Answer each question by placing a check mark in the appropriate box.

You must attach a statement of explanation for all areas marked yes.

Page 3 of 3

Main Menu

Getting Started

Application

Fees


Identity

Fingerprints

Passport Photos


Drug Test

Checklist


General

Section I

Section II

Section III

Section IV

Section V

Section VI





When you sign & date the application, you are certifying that the information is true and correct. False statements are grounds for denial as well as criminal & financial penalty…

Sign Here (Mandatory) Date


Section IV is for original license applicants only and does not apply to entry-level MMDs.

Main Menu

Getting Started

Application

Fees


Identity

Fingerprints

Passport Photos


Drug Test

Checklist


General

Section I

Section II

Section III

Section IV

Section V

Section VI




Section IV...Section IV...


Read the National Driver Registry (NDR) consent authorization carefully.

Sign and date to authorize the NDR search. Your consent authorization is mandatory.

The Mariner’s Tracking System is optional. If you want to participate, you must sign and date these boxes.

Main Menu

Getting Started

Application

Fees


Identity

Fingerprints

Passport Photos


Drug Test

Checklist


General

Section I

Section II

Section III

Section IV

Section V

Section VI




Section V...Section V...


Sign Here (Optional) Date


Read the Certification carefully.

Sign and date certifying that the information is true and correct.

The oath is required, but must be witnessed by a Coast Guard Official. Please leave this blank until you make application in-person.

Main Menu

Getting Started

Application

Fees


Identity

Fingerprints

Passport Photos


Drug Test

Checklist


General

Section I

Section II

Section III

Section IV

Section V

Section VI




Section VI...Section VI...



Sections VII through IX are for U. S. Coast Guard use only. Do not fill out these boxes.

Main Menu

Getting Started

Application

Fees


Identity

Fingerprints

Passport Photos


Drug Test

Checklist


General

Section I

Section II

Section III

Section IV

Section V

Section VI




Sections VII through IX...Sections VII through IX...

FeesFees

You can pay by check, money order, credit card, debit card, and some RECs accept cash.

Use the sub-menu link to view or print the credit or debit card authorization form.

You can pay on-line at https://www.pay.gov/paygov. Print your receipt and include it with your application.

Make checks and money orders payable to the U. S. Coast Guard. Include your SSN in the memo area.

Main Menu

Getting Started

Application

Fees


Identity

Fingerprints

Passport Photos


Drug Test

Checklist

Fees Sub-Menu

General

Fee Chart

Credit Card Authorization Form


https://www.pay.gov/paygov

Transaction Amount

Evaluation Fee for Original Entry Level Rating MMD $95.00

Issuance Fee for Original Entry Level Rating MMD $45.00

Total Fees Due: $140.00

FeesFees

It is highly recommended that you pay both the evaluation fee and the issuance fee when you make application.

Main Menu

Getting Started

Application

Fees


Identity

Fingerprints

Passport Photos


Drug Test

Checklist

Fees Sub-Menu

General

Fee Chart

Credit Card Authorization Form

Fee Chart...Fee Chart...

Citizenship and NationalityCitizenship and Nationality

U.S. Citizens:

Original proof of citizenship is required.

Nationality of Aliens:

Original proof of nationality is required. Aliens must also provide evidence from the U.S. Citizenship and Immigration Services that he/she is lawfully admitted to the U.S. for permanent residence. Evidence may be in the form of an alien registration receipt card issued by the U.S. Citizenship and Immigration Services bearing the certification that the alien was admitted to the U.S. as an immigrant, or a declaration of intention to become a citizen of the U.S. issued

by a naturalization court.

Use the sub-menu link to view the acceptable identification and citizenship documents. Make sure you read the foot notes at the bottom of the document.

Main Menu

Getting Started

Application

Fees


Identity

Fingerprints

Passport Photos


Drug Test

Checklist

Citizenship & Nationality Sub-Menu

Requirements

Acceptable Citizenship / ID

Requirements...Requirements...

IdentityIdentity

Applicants shall present acceptable proof of identity.

Use the sub-menu link to view the acceptable identification and citizenship documents. Make sure you read the foot notes at the bottom of the document.

Original social security card (SSC) is required for all applicants.

Proof of identity shall consist of two current forms of identification, one of which shall contain a photo of the applicant. Proof of citizenship or nationality may be acceptable as one of the ID documents.

Main Menu

Getting Started

Application

Fees


Identity

Fingerprints

Passport Photos


Drug Test

Checklist

Identity Sub-Menu

Requirements

Acceptable Citizenship / ID


FingerprintsFingerprints

Fingerprints are required, and they must be taken by REC personnel. Fingerprints from other agencies are no longer accepted.

Please be aware, the Safety & Security background checks require fingerprints. Therefore, without your fingerprints, your application will be delayed.

Main Menu

Getting Started

Application

Fees


Identity

Fingerprints

Passport Photos


Drug Test

Checklist

Fingerprints Sub-Menu

Requirements


Passport PhotosPassport Photos

2 passport photos are required for entry-level MMDs.

You must also sign the Mariner Identification System Scanner Image Capture Form and submit it with your application. Sign in the middle of the box without touching the lines.

Use the sub-menu link to view or print the Mariner Identification System Scanner Image Capture Form.

Main Menu

Getting Started

Application

Fees


Identity

Fingerprints

Passport Photos


Drug Test

Checklist

Passport Photos Sub-Menu

General

View / Print Camera Form


Certification of FitnessCertification of Fitness

All entry-level MMD transactions require certification of fitness.

Incomplete, inaccurate, and/or missing information will cause significant delays.

Prior to leaving your doctor’s office, take a few minutes to review your certification of fitness for completeness.

The certification of fitness must be dated within 1 year of the application date.

Use the sub-menu link to view or print the certification of fitness form or NVIC 02-98.

Main Menu

Getting Started

Application

Fees


Identity

Fingerprints

Passport Photos


Drug Test

Checklist

Certification of Fitness Sub-Menu

General

Instructions

Section I

Section II

Section III

Section IV

Section V

Medical Waivers

View / Print Cert. Of Fitness Form

View / Print NVIC 02-98



This presentation focuses on the Merchant Marine Certification of Fitness for Entry Level Ratings, CG-719K/E.

The Merchant Mariner Physical Examination Report, CG-719K may also be used to satisfy the requirements, but is much more detailed.

Main Menu

Getting Started

Application

Fees


Identity

Fingerprints

Passport Photos


Drug Test

Checklist


General

Instructions

Section I

Section II

Section III

Section IV

Section V

Medical Waivers



Instructions...Instructions...


These blocks are self explanatory, however they must be complete.

Main Menu

Getting Started

Application

Fees


Identity

Fingerprints

Passport Photos


Drug Test

Checklist


General

Instructions

Section I

Section II

Section III

Section IV

Section V

Medical Waivers



Section I...Section I...

SMITH, JOSEPH, WILLIAM XXX-XX-XXXX


These blocks are self explanatory, however they must be complete.

Main Menu

Getting Started

Application

Fees


Identity

Fingerprints

Passport Photos


Drug Test

Checklist


General

Instructions

Section I

Section II

Section III

Section IV

Section V

Medical Waivers



Section II...Section II...

5 10 GREEN

165 BROWN

TATOO ON LEFT UPPER ARM


This section requires your full attention.

Prior to leaving your doctor’s office, ensure that all the blocks have been filled out.

Entries must be specific and legible.

The next few slides break this section down for easier understanding.

Page 1 of 3

Main Menu

Getting Started

Application

Fees


Identity

Fingerprints

Passport Photos


Drug Test

Checklist


General

Instructions

Section I

Section II

Section III

Section IV

Section V

Medical Waivers





The list of requirements.

Applicant does not have the physical strength, agility, and flexibility, not competent, OR needing further review are considered disqualifying.

Page 2 of 3

If the applicant can perform all the items listed and is considered competent, the following blocks must be marked with an “X”.

Main Menu

Getting Started

Application

Fees


Identity

Fingerprints

Passport Photos


Drug Test

Checklist


General

Instructions

Section I

Section II

Section III

Section IV

Section V

Medical Waivers





Page 3 of 3

Name, license, telephone, and address of physician are required.

The certification of fitness must be signed and dated by your doctor.

Main Menu

Getting Started

Application

Fees


Identity

Fingerprints

Passport Photos


Drug Test

Checklist


General

Instructions

Section I

Section II

Section III

Section IV

Section V

Medical Waivers




Physician Signs Here (Mandatory) Date


You must sign and date the certification of fitness certifying the information is complete and true.

Main Menu

Getting Started

Application

Fees


Identity

Fingerprints

Passport Photos


Drug Test

Checklist


General

Instructions

Section I

Section II

Section III

Section IV

Section V

Medical Waivers



Section IV...Section IV...

Mariner Signs Here (Mandatory) Date


This section contains a detailed description of the requirements, but nothing is required to be filled out or signed.

Main Menu

Getting Started

Application

Fees


Identity

Fingerprints

Passport Photos


Drug Test

Checklist


General

Instructions

Section I

Section II

Section III

Section IV

Section V

Medical Waivers



Section V...Section V...


The below listed medical conditions may need further review. If supporting documentation is requested by the NMC or REC, these checklists may be helpful.

Cardiac ConditionsDiabetes

General Conditions (Not Addressed Above)

HearingPhysical HandicapsPsychotropic DrugsVision

Waivers are considered on a case by case basis.

Main Menu

Getting Started

Application

Fees


Identity

Fingerprints

Passport Photos


Drug Test

Checklist


General

Instructions

Section I

Section II

Section III

Section IV

Section V

Medical Waivers



Medical Waivers...Medical Waivers...

Drug TestDrug Test

A drug test is required for all original entry-level rating MMD transactions.

Only a DOT 5 panel test via a SAMHSA lab will be accepted.

There are 3 options available to satisfy the drug testing requirements.

Use the sub-menu link to view or print the periodic drug test form, NMC GD 03-04 for additional instructions.

Main Menu

Getting Started

Application

Fees


Identity

Fingerprints

Passport Photos


Drug Test

Checklist

Drug Test Sub-Menu

General

Option 1 (Periodic Testing)

Option 2 (Random Testing)

Option 3 (Pre-Employment Testing)

Periodic Drug Test Form

NMC GD 03-04

Additional Drug Test Instructions


Drug TestDrug Test

A USCG drug testing conducted within the past six months in accordance with the procedures established in 49 CFR, part 40, and the USCG.

Make sure that the testing laboratory is on the SAMHSA laboratory list which can be obtained at http://workplace.samhsa.gov/DrugTesting/Level_1_Pages/CertifiedLabs.aspx.

A list of service agents that can assist in meeting these requirements can be obtained at www.uscg.mil/hq/g-m/moa/dapip.htm.

Use the sub-menu link to view or print the periodic drug test form.

Make sure the drug testing Custody and Control Form (CCF) has the word “Federal” in the form header.

Main Menu

Getting Started

Application

Fees


Identity

Fingerprints

Passport Photos


Drug Test

Checklist

Drug Test Sub-Menu

General





NMC GD 03-04


Option 1 (Periodic Testing)...Option 1 (Periodic Testing)...

http://www.uscg.mil/hq/g-m/moa/dapip.htm

Drug TestDrug Test

An original dated letter on marine employer stationary or, for active duty military members, an original dated letter from your command on command letterhead attesting to participation in a random drug testing program.

Example (From Marine Employer):

Applicant’s Name / SSN has been subject to a random drug testing program meeting the criteria of Title 46 CFR 16.230 for at least 60 days during the previous 185 days and has not failed nor refused to participate in a chemical test for dangerous drugs.

Example (Active Duty Military/Military Sealift Command/NOAA/Army Corps of Engineers):

Applicant’s Name / SSN has been subject to a random drug testing program and has never refused to participate in or failed a chemical test for dangerous drugs.

Main Menu

Getting Started

Application

Fees


Identity

Fingerprints

Passport Photos


Drug Test

Checklist

Drug Test Sub-Menu

General





NMC GD 03-04


Option 2 (Random Testing)...Option 2 (Random Testing)...

Drug TestDrug Test

An original dated letter on marine employer stationary signed by a company official, stating that you have passed a pre-employment chemical test for dangerous drugs within the past six months.Example:

Applicant’s Name / SSN passed a chemical test for dangerous drugs, required under Title 46 CFR 16.210 within the previous six months of the date of this letter with no subsequent positive drug test results during the remainder of the six month period.

The letter must also include:

Name & Address of SAMHSA lab.

Name & Address of the DOT qualified MRO.

MRO Organization.

Registration Number.

Main Menu

Getting Started

Application

Fees


Identity

Fingerprints

Passport Photos


Drug Test

Checklist

Drug Test Sub-Menu

General





NMC GD 03-04


Option 3 (Pre-Employment Testing)...Option 3 (Pre-Employment Testing)...

ChecklistChecklist

Page 1 of 4

Main Menu

Getting Started

Application

Fees


Identity

Fingerprints

Passport Photos


Drug Test

Checklist

Checklist Sub-Menu

Checklist

View / Print Checklist

Checklist (1 of 4)...Checklist (1 of 4)...

USCG Credential IssuedUSCG Credential Issued

Complete & Accurate Application

Proper User Fees

Original Proof of Citizenship or Nationality

2 Passport Photos & Camera Set-up Form

Complete & Accurate Certification of Fitness

Acceptable (negative) Drug Test

Original Proof of Identity & SSN

Safety & Security Background Clearance

Fingerprinted by REC PersonnelReturn to Applicant

ChecklistChecklist

Application:

Sect I: Ensure your mailing address is correct.

Sect II: Write “Entry-level MMD” in the applying for box.

Sect III: Read the definition of conviction & answer the questions honestly. Sect III: Write a statement for all “yes” answers (when, where & what).

Sect III: Sign & Date attesting that your answers are truthful. Sect V: Sign and Date the NDR consent. Sect VI: Sign and Date certifying the application is true and correct.

Fees: Include $140.00 with your application. You can pay by check; money order, credit/debit card, pay.gov, & some RECs accept cash.

Page 2 of 4

Sect I: Verify that every block is filled out, or write “N/A”.

Sect I: Next of kin name, address and relationship is required by law.

Sect III: Provide court documentation for recent convictions (5 years).

Use the sub-menu link to print the checklist.

Main Menu

Getting Started

Application

Fees


Identity

Fingerprints

Passport Photos


Drug Test

Checklist

Checklist Sub-Menu

Checklist



ChecklistChecklist

Identity: Two current forms of identification are required, one of which shall contain a photo of the applicant.

Fingerprints: Fingerprints are required, and they must be taken by REC personnel.

Page 3 of 4

Original social security card is required for all applicants.

Citizenship & Nationality: For U.S. Citizens: Original proof of citizenship required. For Aliens: Original proof of nationality & evidence of lawful admittance to U.S. for permanent residence required.

Sign the camera form & include it with your package. Two passport photos required.Passport Photos:


Main Menu

Getting Started

Application

Fees


Identity

Fingerprints

Passport Photos


Drug Test

Checklist

Checklist Sub-Menu

Checklist



ChecklistChecklist

Page 4 of 4

Drug Test: Periodic: MRO signed the document. Periodic: Document is original; photocopies are unacceptable. Random & Pre-employment: Original company letter meets requirements.

Delivery of Application Package: Bring your completed application and associated documentation to a REC in-person.

Include a completed checklist with your application package.

Certification of Fitness: Verify that every block is filled out properly. Section III: Ensure all the physician contact information is filled out, and ensure that your physician signed and dated the form. Section IV: Sign and date, certifying the information is true.


Main Menu

Getting Started

Application

Fees


Identity

Fingerprints

Passport Photos


Drug Test

Checklist

Checklist Sub-Menu

Checklist



The EndThe End

Use the navigation links on the main menu to review information as needed.

The USCG is committed to providing you with excellent service. Please help us improve our processes by commenting on the service you received. Your feedback will be used to guide our efforts in the future. Click here to view or print the Survey Form.

Main Menu

Getting Started

Application

Fees


Identity

Fingerprints

Passport Photos


Drug Test

Checklist

Review / Program Survey...Review / Program Survey...

entry - level mmd w i z a r d u. s. coast guard mariner licensing & documentation entry-level...

Documents

started main menu

fax honolulu uscg rec

fax boston uscg rec

fax juneau uscg rec

fax houston uscg rec

baltimore uscg rec baltimore

memphis uscg rec memphis

anchorage uscg rec anchorage