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District 17 Contact Questionnaire

If you have comments or questions about any of our activities or programs you can contact us using this form.  Please complete this Questionnaire as it will assist the Flotilla in understanding your interests so we can provide you with the best information.

Contact Information

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TOPIC OF INTEREST
Please Select all topics that interest you:
	General Information
	Boater Safety Class
	Vessel Safety Check
	Membership Information
	Schedule a Speaker
	Other

We look forward to hearing from you.
 Richard Fairbanks, Personnel Officer
US Coast Guard Auxiliary District 17, Alaska
Pat Fairbanks