Form Cg-4887 Form Ansc7026 "Auxiliary Operational Specialty Course Examination Request/Transmittal Form"

Form cg-4887 is a United States Coast Guard form also known as the "Auxiliary Operational Specialty Course Examination Request/transmittal Form". The latest edition of the form was released in August 1, 2010 and is available for digital filing.

Download a fillable PDF version of the Form cg-4887 down below or find it on United States Coast Guard Forms website.

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DEPARTMENT OF
DEPARTMENT OF
DATE
(Month, Day, Year)
DEPAR TMENT OF
AUXILIARY OPERATIONAL SPECIALTY COURSE EXAMINATION
HOMELAND SECURITY
HOMELAND SECURITY
TRANSPOR TATION
US COAST GUARD
US COAST GUARD
U. S. COAST GUARD
REQUEST/TRANSMITTAL FORM
CG-4887 (08-10) ANSC 7026
CG-4887 (08-10) ANSC 7026
CG-4887 (1-02)
ANSC# 7026
INSTRUCTIONS:
1. Submit original and 2 copies to Director of Auxiliary
2. Form may be completed with ball point pen. Please print.
HOW MANY TIMES
FOR DIRAUX
HAS APPLICANT
NAME OF EXAMINATION
USE ONLY
TAKEN AN
MEMBER ID
LAST NAME
FIRST NAME
INITIAL
REQUESTED
EXAM IN THIS
EXAMINATION
SUBJECT
SERIAL NO.
1. It is requested that the OSC exam for the above listed members be administered on _______________ ,
20 ____ .
2. For those members who have taken and failed a previous examination in the same subject, the required time will have
passed by the date of administration requested above.
3. Arrangements for conducting the examinations may be made by contacting the Auxiliarist whose name, address and
telephone number is listed below.
Name __________________________________________________________
Address _______________________________________________________
Telephone ___________________________________________________
____________________________________________________________
Signature of FSO-MT or FC
FIRST ENDORSEMENT
Date _____________________________________________
From:
To:
1. You are requested to administer the enclosed examinations in accordance with the instructions on the reverse side of
this form.
_____________________________________________________
Signature of Director of Auxiliary
SECOND ENDORSEMENT
Date ____________________________________________
From:
To:
1. The examinations were administered on _____________ 2 0 _____ at ________________________________________________________
by me in accordance with the instructions on the reverse of this form. Those examinations which were not administered
are: (1) indicated by an asterisk (*) by the serial number listed above, (2) returned unopened, and (3) were not
administered for the following reason:
________________________________________________________
Signature of Proctor
CLICK TO CLEAR ALL DATA
Previous edition may be used until supplies are exhausted
DEPARTMENT OF
DEPARTMENT OF
DATE
(Month, Day, Year)
DEPAR TMENT OF
AUXILIARY OPERATIONAL SPECIALTY COURSE EXAMINATION
HOMELAND SECURITY
HOMELAND SECURITY
TRANSPOR TATION
US COAST GUARD
US COAST GUARD
U. S. COAST GUARD
REQUEST/TRANSMITTAL FORM
CG-4887 (08-10) ANSC 7026
CG-4887 (08-10) ANSC 7026
CG-4887 (1-02)
ANSC# 7026
INSTRUCTIONS:
1. Submit original and 2 copies to Director of Auxiliary
2. Form may be completed with ball point pen. Please print.
HOW MANY TIMES
FOR DIRAUX
HAS APPLICANT
NAME OF EXAMINATION
USE ONLY
TAKEN AN
MEMBER ID
LAST NAME
FIRST NAME
INITIAL
REQUESTED
EXAM IN THIS
EXAMINATION
SUBJECT
SERIAL NO.
1. It is requested that the OSC exam for the above listed members be administered on _______________ ,
20 ____ .
2. For those members who have taken and failed a previous examination in the same subject, the required time will have
passed by the date of administration requested above.
3. Arrangements for conducting the examinations may be made by contacting the Auxiliarist whose name, address and
telephone number is listed below.
Name __________________________________________________________
Address _______________________________________________________
Telephone ___________________________________________________
____________________________________________________________
Signature of FSO-MT or FC
FIRST ENDORSEMENT
Date _____________________________________________
From:
To:
1. You are requested to administer the enclosed examinations in accordance with the instructions on the reverse side of
this form.
_____________________________________________________
Signature of Director of Auxiliary
SECOND ENDORSEMENT
Date ____________________________________________
From:
To:
1. The examinations were administered on _____________ 2 0 _____ at ________________________________________________________
by me in accordance with the instructions on the reverse of this form. Those examinations which were not administered
are: (1) indicated by an asterisk (*) by the serial number listed above, (2) returned unopened, and (3) were not
administered for the following reason:
________________________________________________________
Signature of Proctor
CLICK TO CLEAR ALL DATA
Previous edition may be used until supplies are exhausted
(08/10)
Reverse of CG-4887 (1-02)
INSTRUCTIONS
1. The proctor must be a person in one of the following categories:
a. A commissioned, warrant, or petty officer of the regular Coast Guard or Coast Guard Reserve on
active duty.
b. A commissioned or warrant officer of the Coast Guard Reserve on inactive duty.
c. An AUXOP member of the Coast Guard Auxiliary who has been specifically designated by the director
of Auxiliary to administer Operational Specialty Examinations.
2. The proctor shall be present with examinees throughout the examination.
3. The proctor shall not answer substantive questions about the examination or allow students to assist
each other in any way.
4. The proctor shall not open the examination envelope until all students are seated and ready to begin. At
that time he shall pass out the examinations, answer sheets, No. 2 lead pencils, and scratch paper and
read aloud the following instructions to the students:
a.
Check the subject of the examination provided to be sure that this is the examination requested.
b.
Place in front of you the blank answer sheet provided.
(1) Carefully make all marks on this answer sheet with the No. 2 black lead pencil provided. Be
careful to make no stray pencil marks on the answer sheet as it will be machine-graded. To
avoid erasures, it is suggested that at first you mark your selection lightly with a small dot.
Then, after you are satisfied that no changes will be made, darken the blocks carefully.
(2) Print your name, last name first, on the line provided.
(3) Enter your 7 digit Member ID Number.
(4) On the line marked Exam Title, enter the name of the examination as listed on the front of your
examination booklet.
(5) Under Member’s Mailing Address, list the address to which you desire the results of this
examination to be mailed.
(6) In the block entitled Date of Examination, first darken the space under the appropriate month.
Under “Ten’s digit” darken the space corresponding to the first digit in the date, a zero if it is
the 1-9th of the month. Under “Unit’s digit” mark the second digit of the date.
(7) Enter your Social Security number in the block provided, starting at the top.
(8) Enter the 3 digit course code, the 1 digit edition number and the 2 digit test number (not the
serial number) found on the front of the examination booklet.
(9) Enter the 7 digit OPFAC number listed on the front of the examination booklet.
(10) Now blacken in the appropriate spaces to the right of the blocks you have just completed.
c.
Any marks made in the examination booklet will result in the disqualification of the student. There
is no time limit, but the test must be taken in one sitting, and without breaks. You may talk with no one
but me during this examination. All examination booklets, answer sheets, scratch paper and pencils shall
be returned to me at the completion of the examination. No copies of the examination or of the answers, or
of any portions thereof either directly or in paraphrase form shall be made or divulged. YOU MAY BEGIN
NOW.
5. When all students are finished, all answer sheets, scratch paper, and copies of the examinations shall
be placed in the smaller of the two envelopes provided and the envelope sealed. No copies shall be retained
for administering at a later time. Such postponements shall constitute an additional examination and the
request for such postponed examinations shall be processed in accordance with procedures established by
the Director of Auxiliary.
6. After the examination envelope is sealed, the second endorsement on this form shall be completed by
the proctor. The original of this form shall be placed on the outside of the (inner) envelope, and the copy
retained by the proctor for his records.
7. The proctor shall then enclose the examination envelope in the larger envelope provided and mail it
promptly to the Director of Auxiliary.
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