CTMD Form 1-3 "Application for Membership in the Governor's Guards" - Connecticut

What Is CTMD Form 1-3?

This is a legal form that was released by the Connecticut Military Department - a government authority operating within Connecticut. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on August 1, 2019;
  • The latest edition provided by the Connecticut Military Department;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of CTMD Form 1-3 by clicking the link below or browse more documents and templates provided by the Connecticut Military Department.

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Download CTMD Form 1-3 "Application for Membership in the Governor's Guards" - Connecticut

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CLEAR FORM
CTMD Form 1-3
(Rev. 8/2019)
CONNECTICUT MILITARY DEPARTMENT
APPLICATION FOR MEMBERSHIP
IN THE GOVERNOR’S GUARDS
PURPOSE:
To record enlistment into the Armed Forces of the State of Connecticut and the
Governor’s Guards.
AUTHORITY:
Connecticut General Statutes Sections 27-20 and 27-56; General Order 2010-
2/CTMD Regulation 600.
INSTRUCTIONS: The applicant will complete all sections correctly and accurately to the best of their
knowledge. A member of the unit should assist the applicant through the enlistment process to
answer any questions the applicant may have. All sections and questions need to be answered or
the application will be returned for incompleteness. If NONE or N/A is the appropriate answer, please
indicate as such. The Adjutant of the gaining unit will review the application and will collect all
substantiating documentation for the applicant’s personnel record.
The original document will be retained at the unit and a copy.
BACKGROUND INFORMATION: Questions answered YES will not necessarily disqualify an
applicant from membership in the Governor’s Guards but may limit the applicant from specific duty
positions, titles or rank. Each application will be evaluated on its own merit.
SUPPORTING DOCUMENTATION:
□ Proof of citizenship
□ Proof of CT residency
□ Verification of Social Security Number
□ Documentation of prior military service
□ Documentation to any question answered YES in BACKGROUND
INFORMATION
SEND COPIES OF APPLICATIONS & SUPPORTING DOCUMENTATION TO:
Connecticut Military Department
Military Administrative Officer
360 Broad Street Room #113
Hartford, Connecticut, 06105-3706
(860) 493-2721 (fax)
Page 1 of 3
CLEAR FORM
CTMD Form 1-3
(Rev. 8/2019)
CONNECTICUT MILITARY DEPARTMENT
APPLICATION FOR MEMBERSHIP
IN THE GOVERNOR’S GUARDS
PURPOSE:
To record enlistment into the Armed Forces of the State of Connecticut and the
Governor’s Guards.
AUTHORITY:
Connecticut General Statutes Sections 27-20 and 27-56; General Order 2010-
2/CTMD Regulation 600.
INSTRUCTIONS: The applicant will complete all sections correctly and accurately to the best of their
knowledge. A member of the unit should assist the applicant through the enlistment process to
answer any questions the applicant may have. All sections and questions need to be answered or
the application will be returned for incompleteness. If NONE or N/A is the appropriate answer, please
indicate as such. The Adjutant of the gaining unit will review the application and will collect all
substantiating documentation for the applicant’s personnel record.
The original document will be retained at the unit and a copy.
BACKGROUND INFORMATION: Questions answered YES will not necessarily disqualify an
applicant from membership in the Governor’s Guards but may limit the applicant from specific duty
positions, titles or rank. Each application will be evaluated on its own merit.
SUPPORTING DOCUMENTATION:
□ Proof of citizenship
□ Proof of CT residency
□ Verification of Social Security Number
□ Documentation of prior military service
□ Documentation to any question answered YES in BACKGROUND
INFORMATION
SEND COPIES OF APPLICATIONS & SUPPORTING DOCUMENTATION TO:
Connecticut Military Department
Military Administrative Officer
360 Broad Street Room #113
Hartford, Connecticut, 06105-3706
(860) 493-2721 (fax)
Page 1 of 3
CTMD Form 1-3
(Rev. 8/2019)
CONNECTICUT MILITARY DEPARTMENT
APPLICATION FOR MEMBERSHIP IN THE GOVERNOR’S GUARDS
UNIT:
First Company Governor’s Foot Guard – Hartford, CT
Second Company Governor’s Foot Guard – Branford, CT
First Company Governor’s Horse Guard – Avon, CT
Second Company Governor’s Horse Guard – Newtown, CT
APPLICANT INFORMATION
Last Name
First Name
Middle Initial
Mailing Address
City
State
Zip Code
Primary Phone Number
Secondary Phone Number
E-Mail
Date of Birth
Place of Birth (City/State)
Social Security Number
U.S. Citizenship
Marital Status
YES
Married
Divorced
NO
Single
Widowed
If NO, provide Alien Registration Number:
Dependent Status:
Children aged 18 or younger living with you:
Children aged 19-22 and in college
Name:
Date of Birth:
Name:
Date of Birth:
EMPLOYMENT & EDUCATION INFORMATION
Current Employment
Education
Name of Employer
Highest Level of Education & Name of Academic Institution
Position/Title
Years at Employer
Type of Degree/Certificate
Field of Study
Other Employment:
Other degrees, certificates or training:
PRIOR MILITARY SERVICE
(list in chronological order if breaks in service or change in branch or component -- provide documentation)
Branch
Component
Rank
Specialty
Type of Discharge
Start Date
End Date
Page 2 of 3
CTMD Form 1-3
(Rev. 8/2019)
CONNECTICUT MILITARY DEPARTMENT
APPLICATION FOR MEMBERSHIP IN THE GOVERNOR’S GUARDS
BACKGROUND INFORMATION
Have you ever been discharged from the Armed Forces of the United States in conditions other than HONORABLE:
YES
NO
If YES, please explain type of discharge and why
Have you ever been arrested?
YES
NO
If YES, please provide dates, type of offense and disposition
Have you ever been imprisoned?
YES
NO
If YES, please provide dates and name of correctional facility
Have you ever been convicted of a felony?
YES
NO
If YES, please provide dates, type of offense
Do you have a juvenile record
YES
NO
If YES, please provide dates, type of offense and disposition
Are you currently undergoing court action of any kind?
YES
NO
If YES, please provide details
CERTIFICATION
I certify that I have carefully read this document, any questions I had were explained to my satisfaction. I certify that all
information provided on this document is accurate and correct to the best of my knowledge. Providing false information or
failing to disclose information will result in the immediate discharge from the Governor’s Guards.
Signature of Enlistee
Date
TO BE COMPLETED BY UNIT:
Position Assigned:
Date of Enlistment:
Supporting documentation completed:
Police Record Check – Form 1-4
Injury Reporting Procedures – Form 1-12
Gratuitous Service Acknowledgement – Form 1-13
Qualification to Possess Firearms or Ammunition – Form 1-14
Fraternization Policy – Form 1-15
Acceptable Use Policy – Form 1-17
Physical Examination – Standard Form 88
Signature of Officer
Date
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