CITF Registration This field is hidden when viewing the formFull name, as it appears on Driver's LicenseFirst Name (as it appears on Driver's License)(Required)Middle Name (as it appears on Driver's License)Last Name (as it appears on Driver's License)(Required)Date of Birth(Required) MM slash DD slash YYYY UBC ID(Required)Local #(Required)Preferred Email(Required) Cell Phone(Required)Address(Required) Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Departure Airport(Required)Employer Name(Required)Job Title(Required)Male/Female(Required) Male Female As listed on driver’s license, for making flight arrangements.Shirt Size (unisex)(Required)SMLXL2XL3XL4XL5XLDietary RestrictionsPhysical RestrictionsEmergency Contact(Required)Emergency Contact (Relationship)(Required)Emergency Contact Phone(Required)PhoneThis field is for validation purposes and should be left unchanged.
