Protected: SSGT Vanguard, COR-Tactics & Edged Weapon Survival Student Course Information Submission Form This content is password protected. To view it please enter your password below: Password: SSGT Vanguard, SSGT COR-Tactics & Edged Weapon Survival Student Course Information If you are a human and are seeing this field, please leave it blank. Fields marked with an * are required Certifying Instructor's Last Name * Certifying Instructor's First Name * Certifying Instructor's Phone * Certifying Instructor's Email * Male Female Certifying Instructor's City * Certifying Instructor's State * Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Certifying Instructor's Agency * City of Certifying Instructor's Agency * State of Certifying Instructor's Agency * Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming List All Co-Instructors and Their Agencies if Applicable Course Location and Address * Student Names, Email Addresses and [Dates of Training From & To -at top of form] * Vanguard Level One: Students listed above were; Select Fully certified in all categories Re-certified in all categories Fully certified in only select categories Re-certified in only select categories Not certified in any part of Level One Please provide the Vanguard Level One Categories in which the students listed above were "selectively" certified re-certified if applicable. Provide only the "Category Number" e.g., Categories 3, 4, and 5. Vanguard Level Two: Students listed above were; Select Fully certified in all categories Re-certified in all categories Fully certified in only select categories Re-certified in only select categories Not certified in any part of Level Two Please provide the Vanguard Level Two Categories in which the students listed above were "selectively" certified or re-certified if applicable. Provide only the "Category Number" e.g., Categories 3, 4, and 5. COR-Tactics: Students listed above were; Select Fully certified in all categories Re-certified in all categories Fully certified in only select categories Re-certified in only select categories Not certified in any part of COR-Tactics Please provide the COR-Tactics Categories in which the students listed above were "selectively" certified or re-certified if applicable. Provide only the "Category Number" e.g., Categories 3, 4, and 5. Edged Weapon Survival: Students listed above were; Select Fully certified in all categories Re-certified in all categories Fully certified in only select categories Re-certified in only select categories Not certified in any part of Edged Weapon Survival Please provide the Edged Weapon Survival Categories in which the students listed above were "selectively" certified or re-certified if applicable. Provide only the "Category Number" e.g., Categories 3, 4, and 5. Checking the box below signifies that I, the certifying instructor, attest and affirm that all students listed above completed and passed all related written and practical exams necessary for student certification. Checking the box below signifies that I, the certifying instructor, attest and affirm that all students listed above filled out both the SSGT Physical Preparedness Form and the SSGT Release of Liability Form. Checking the box below signifies that I, the certifying instructor, attest and affirm that there were no injuries sustained by any participant in the above mentioned course. Checking the box below signifies that I, the certifying instructor, attest and affirm that there was an injury or injuries sustained by a participant or participants in the above mentiond course and a course injury form or forms was filled out and submitted to the SSGT webiste.
