Form CG-5223 Form Ansc 7059 - Short Term Resident Training Request

Form CG-5223 is a United States Coast Guard form also known as the "Short Term Resident Training Request". The latest edition of the form was released in May 1, 2010 and is available for digital filing.

Download an up-to-date fillable Form CG-5223 in PDF-format down below or look it up on the United States Coast Guard Forms website.

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Rev004
Auxiliary Use Only
1. DATE (M)
SHORT-TERM RESIDENT
See Instructions on page 2!!!
TRAINING REQUEST
2. REQUEST STATUS (Check one)
DEPARTMENT OF
TRANSPORTATION
A. (M)
C. (M)
U.S. COAST GUARD
INITIAL
CORRECTED
(Information on this form are Privacy Act Protected, 5USC 522(a))
CG-5223 (Rev
)
ANSC 7059
B. RESUB-
D. CANCEL-
(When filling in items 1. thru 22. NOTE
MISSION (M)
LATION (M)
( M ) MANDATORY or ( O ) OPTIONAL
3. SOC. SECURITY NO. (M)
4. NAME (Last, Initials) (M)
5. RANK/RATE (M)
6. ROTATION DATE (Estimate) (M)
N/A
YEAR
MONTH
CIV/AUX
Not Applicable
9. MEMBER NUMBER (M)
7. COURSE TITLE/NUMBER (M)
8. FLOTILLA(M)
Course Title:
10. POINT OF CONTACT (FSO-MT name) (M)
11.FSO-MT TELEPHONE NUMBER (M)
Course Number:
Note:Aux 12 is part of the title,
AREA CODE
NUMBER
EXT
not the course number etc.
14. BILLING ADDRESS (When applicable) (O)
15. PRIORITY (Code) (M)
12. TRAINING SOURCE/LOCATION (M)
16. COURSE DURATION (M)
Not Applicable
13. TUITION AND FEES (When applicable) (O)
WEEKS
DAYS
Not Applicable
17. COURSE CONVENING PREFERENCE (M)
A. FIRST CHOICE (M)
B. SECOND CHOICE (M)
C. THIRD CHOICE (M)
YEAR
MONTH
DAY
YEAR
MONTH
DAY
YEAR
MONTH
DAY
19. MEETS COURSE PREREQUISITES (M)
18. STAFF OFFICER POSITIONS HELD (M)
20. LENGTH OF AUXILIARY SVC (YRS) (M)
( e.g.Prior courses/rate)
(Check applicable box)
YES
NO
N/A
21. TRAINING NEEDS ANALYSIS (M)
A. NO. PERSONNEL UNIT (M)
B. NO. PERSONNEL WITH
C. NO. PERSONNEL "ORDERED IN"
D. NO. PERSONNEL "ORDERED
Not Applicable
REQUIRED TRAINED IN COURSE
TRAINING O/B (M)
WITH TRAINING (M)
OUT" WITH TRAINING (M)
22. SUPPORTING REMARKS AND COURSE DESCRIPTION (Attach course literature; for commercial sources).
(O)
Member Full Name:
Address (No PO Box)
Phone:
Email Address:
23. FIRST ENDORSEMENT FORWARDED
B. DATE
A. FLOTILLA
APPROVED
C. REMARKS
DISAPPROVED (Remarks required)
D. TITLE
E. SIGNATURE
Flotilla Commander
24. SECOND ENDORSEMENT FORWARDED
B. DATE
A. DIST/UNIT/DIRAUX
APPROVED
C. REMARKS
Not Applicable
DISAPPROVED (Remarks required)
D. TITLE
E. SIGNATURE
25. QUOTA STATUS (Action office use only)
A. QUOTA REQUIRED
B. QUOTA REQUESTED
C. QUOTA GRANTED
REASON NOT GRANTED
Not Applicable
YES
NO
YES
NO
YES
NO
PREVIOUS EDITION IS OBSOLETE
5E5.05G
Print
Clear Form
Rev004
Auxiliary Use Only
1. DATE (M)
SHORT-TERM RESIDENT
See Instructions on page 2!!!
TRAINING REQUEST
2. REQUEST STATUS (Check one)
DEPARTMENT OF
TRANSPORTATION
A. (M)
C. (M)
U.S. COAST GUARD
INITIAL
CORRECTED
(Information on this form are Privacy Act Protected, 5USC 522(a))
CG-5223 (Rev
)
ANSC 7059
B. RESUB-
D. CANCEL-
(When filling in items 1. thru 22. NOTE
MISSION (M)
LATION (M)
( M ) MANDATORY or ( O ) OPTIONAL
3. SOC. SECURITY NO. (M)
4. NAME (Last, Initials) (M)
5. RANK/RATE (M)
6. ROTATION DATE (Estimate) (M)
N/A
YEAR
MONTH
CIV/AUX
Not Applicable
9. MEMBER NUMBER (M)
7. COURSE TITLE/NUMBER (M)
8. FLOTILLA(M)
Course Title:
10. POINT OF CONTACT (FSO-MT name) (M)
11.FSO-MT TELEPHONE NUMBER (M)
Course Number:
Note:Aux 12 is part of the title,
AREA CODE
NUMBER
EXT
not the course number etc.
14. BILLING ADDRESS (When applicable) (O)
15. PRIORITY (Code) (M)
12. TRAINING SOURCE/LOCATION (M)
16. COURSE DURATION (M)
Not Applicable
13. TUITION AND FEES (When applicable) (O)
WEEKS
DAYS
Not Applicable
17. COURSE CONVENING PREFERENCE (M)
A. FIRST CHOICE (M)
B. SECOND CHOICE (M)
C. THIRD CHOICE (M)
YEAR
MONTH
DAY
YEAR
MONTH
DAY
YEAR
MONTH
DAY
19. MEETS COURSE PREREQUISITES (M)
18. STAFF OFFICER POSITIONS HELD (M)
20. LENGTH OF AUXILIARY SVC (YRS) (M)
( e.g.Prior courses/rate)
(Check applicable box)
YES
NO
N/A
21. TRAINING NEEDS ANALYSIS (M)
A. NO. PERSONNEL UNIT (M)
B. NO. PERSONNEL WITH
C. NO. PERSONNEL "ORDERED IN"
D. NO. PERSONNEL "ORDERED
Not Applicable
REQUIRED TRAINED IN COURSE
TRAINING O/B (M)
WITH TRAINING (M)
OUT" WITH TRAINING (M)
22. SUPPORTING REMARKS AND COURSE DESCRIPTION (Attach course literature; for commercial sources).
(O)
Member Full Name:
Address (No PO Box)
Phone:
Email Address:
23. FIRST ENDORSEMENT FORWARDED
B. DATE
A. FLOTILLA
APPROVED
C. REMARKS
DISAPPROVED (Remarks required)
D. TITLE
E. SIGNATURE
Flotilla Commander
24. SECOND ENDORSEMENT FORWARDED
B. DATE
A. DIST/UNIT/DIRAUX
APPROVED
C. REMARKS
Not Applicable
DISAPPROVED (Remarks required)
D. TITLE
E. SIGNATURE
25. QUOTA STATUS (Action office use only)
A. QUOTA REQUIRED
B. QUOTA REQUESTED
C. QUOTA GRANTED
REASON NOT GRANTED
Not Applicable
YES
NO
YES
NO
YES
NO
PREVIOUS EDITION IS OBSOLETE
5E5.05G
Print
Clear Form
Revised
Auxiliary Applicant
Short Term Resident Training Request (CG-5223)
Block 1
Enter date request prepared.
Block 2
Check appropriate request status box.
Block 3
Utilize Social Security Numbers; Privacy Act statement applies.
Block 4
Complete as indicated; request must specify a specific person, not office held.
Block 5
Pre-filled in.
Block 6
Not applicable.
Block 7
Provide course title number: example AUX-01 Career Counselor School.
Block 8
Enter unit title as listed in AUX
: example Flotilla
,
.
Block 9
Enter Auxiliary member number: example
Block 10
Enter name of staff office position of individual to contact for follow up. Typically, this is the
FSO-MT.
Block 11
Insert telephone number with area code for FSO-MT listed in Block 10.
Block 12
Enter command location where training is desired.
Block 13
Not applicable.
Block 14
Not applicable.
Block 15
Use priority codes 1, 2, or 3 as defined below.
1. Essential to mission accomplishment or program objectives (example: All CC officers are
priority 1 for AUX-01 training).
2. Directly relates to mission accomplishment or program objectives and should result in
improved performance (example: members who assist in AIM candidate selection, but are
not appointed officers).
3. Indirectly relates to mission accomplishment.
Block 16
List duration of course.
Block 17
Complete choice as indicated. List any amplifying remarks regarding preference in Block 22.
Block 18
List all current staff officer positions held.
Block 19
Complete as indicated.
Block 20
Length of Auxiliary service (# of years).
Block 21
Not applicable.
Block 22
This block should be used to provide any pertinent information affecting the training request,
for example, if early notification (greater than 4 to 6 weeks before convening) is essential,
provide reason. Auxiliarist must provide mailing address for orders, additional telephone
numbers for notification. Email address is required for AUX-04 (Distance Learning Educa-
tion- Basic), AUX-05 (Virutal Instructor Training, formerly Instructor Training Course), and AUX-
08 (Distance Learning Technology Education- Advanced), and would be helpful for other
classes, such as AUX-03 (Accessions Recruiting Training- formerly Career Counselor Train-
ing). Indicate any physical disabilities that may require special equipment or special dietary
considerations. Due to command policy there are no cohabitation berthing facilities. Indicate
gender (male/female) for berthing purposes at training centers.
Block 23
For command endorsement block, Flotilla Commander should sign and forward applicable
forms to the Director of Auxiliary by mail or fax.
Block 24
Not applicable.
Block 25
Not applicable.
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