LAST NAME FIRST NAME MI GRADE CAPID DATE ENTERED CAP CHARTER NO.

SENIOR MEMBER AWARDS AND DECORATIONS

SENIOR MEMBER MASTER RECORD

AERONAUTICAL RATINGS, PILOT

DESIGNATIONS, AND OTHER OPERATIONS

BADGES

NAME Date Earned INITIAL / ANNUAL AIRCREW TRAINING AND EVALUATION CHECKS Date

Qualified Date Type Year Date Type Year Mission Scanner

Observer

Senior Observer

Master Observer

Pre-Solo Pilot

Solo Pilot

Pilot

Senior Pilot

Command Pilot

Transport Mission Pilot

SAR/DR Mission Pilot

Cadet Orientation Pilot

Instructor Pilot

Check Pilot

Mission Check Pilot

Glider Pilot

Balloon Pilot

FAA INFORMATION Basic Ground Team

FAA Medical Date/Class FAA License Number Senior Ground Team

FAA Ratings Master Ground Team

AIRCRAFT OWNER INFORMATION Basic IC

Aircraft Personally Owned Make and Model Aircraft Number Fuel Cap (Hrs) Senior IC

Yes No N hr / gal Master IC

AEPSM AWARD COMMUNICATIONS TRAINING

GEN CHUCK YEAGER BCUT ACUT FCC LICENSES GROL

CAP FORM 45, AUG 09 PREVIOUS EDITIONS MAY BE USED OPR/ROUTING: DP

PROFESSIONAL DEVELOPMENT RECORD

DIRECTIONS: 1. Level I - Foundations Course is required except as outlined in CAPR 50-17 for Mitchell Award Recipients. Cadet Protection Training cannot be waived for any senior member. 2. Level II – V - Enter date activity was completed. Unit commander certifies by initialing. 3. Specialty Training - Enter date training level was attained. Unit commander initials block. LEVEL I – INTRODUCTION DATE COMPLETED SPECIALTY TRAINING Foundations Course or Mitchell Award CODE/SUBJECT TECHNICIAN SENIOR MASTER Cadet Protection Training OPSEC Training 200 Personnel LEVEL II – TECHNICAL RATING DATE COMPLETED CERTIFICATION 201 Public Affairs Squadron Leadership School (SLS) 202 Finance AFIADL Course 13 or Equivalent 203 Inspector General Specialty Technician Rating 204 Professional Development 205 Administration 206 Logistics LEVEL III – MANAGEMENT DATE COMPLETED CERTIFICATION 210 Flight Operations Command/Staff Position for One Year 211 Operations Corporate Learning Course (CLC) 212 Standardization-Evaluation

1. 213 Emergency Services Attend Two National (N), Regional (R), Wing (W) Conferences 2. 214 Communications Specialty Senior Rating 215 Aerospace Education LEVEL IV – COMMAND AND STAFF DATE COMPLETED CERTIFICATION 216 Cadet Programs Command/Staff Position for Two Years 217 Safety Region Staff College or Equivalent (CAPR 50-17) 218 Plans and Programs

219 Legal 220 Health Services

Serve as a Staff Member at National Region, or Wing Conference, or Serve as Staff Member or Presenter at CAP Course (CAPR 50-17 para 6-1, and Attachment 14)

221 Chaplain 223 Historian 225 Moral Leadership

Prepare and Present a CAP Presentation to a Non-CAP Group on a CAP-Related Subject or Earn the Yeager Award

226 Recruiting and Retention

Specialty Master Rating 227 Information Technology LEVEL V – EXECUTIVE DATE COMPLETED CERTIFICATION 228 Drug Demand Reduction Command/Staff Position for Three Years 229 Organizational Excellence National Staff College or Equivalent (CAPR 50-17) Other:

Conduct “Summary Conversation” for the Level I Foundations Course and one of the Following:

Serve as Director of CAP Course (CAPR

50-17, para 7-1, and Attachment 14)

or Serve as a Staff Member for the Region Staff College

or Serve as a Staff Member for the

National Staff College

PERSONAL INFORMATION Home Address

Unit (Name, Charter, Address)

Date and Place of Birth

Weight Height Eyes Hair Military Service Highest Grade No. of Years Served Present Status

Occupation

EDUCATION – ALL CIVILIAN AND MILITARY SCHOOLS Graduate

From To Name and Location of School Yes No

Degree

DUTY ASSIGNMENTS Inclusive Dates Title Grade Inclusive Dates Title Grade

to to to to to to to to to to

GRADE

NCO Officer

Date Date Date Sergeant Flight Officer Major Staff Sergeant Technical Flight Officer Lieutenant Colonel Technical Sergeant Senior Flight Officer Colonel Master Sergeant Second Lieutenant Brigadier General Senior Master Sergeant First Lieutenant Major General Chief Master Sergeant Captain

ENCAMPMENT AND ACTIVITY PARTICIPATION Activity Name & Location Inclusive Dates Notes (Assignment, DG, etc.) Activity Name & Location Inclusive Dates Notes (Assignment, DG, etc.)

to to

to to

to to

to to

to to

to to

to to

to to

to to

to to

to to

to to

to to

to to

to to

to to

to to

to to

to to

to to

to to

to to

to to

Other Information