Registration - Citizens Action Team

Note to prospective members

Only the members that want to have access to sensitive information (such as the bad guys phone numbers, license numbers, address's, associates etc.) need to pay the $50.00 fee to join. If you do not want to have access to that info, just fill out the form and leave any sensitive information that you do not want to expose blank. We do need an address and a phone number. We want anyone that can help us in our fight, and we know that there are many people who cannot donate or pay the fees, that does not mean you cannot be a valuable member of our team. If you can donate, please do, we need a lot of financial support to be effective.

Registration - For Citizens Action Team. Covering the entire Mohave County

Registration requests may be submitted securely via this website, or mail your application or call (928) 727-0737. All volunteers must be registered in advance to participate in all CAT operations. You must be a minimum of 18 years old to participate as a CAT Volunteer.

A $50 non-refundable volunteer registration fee is required to cover fees for a security background check and administrative costs.

The $50 Registration fee can be waived if you have a current license to Carry a Concealed Weapon (CCW). Below, you will have the option of specifying YOU DO or DO NOT already have your permit. To take advantage of this offer, complete this registration page then SUBMIT it at page bottom. If you already have a Concealed Weapons Permit please mail a legible copy and a copy of your driver's license to:

Citizens Action Team
1894 E BUTLER AVE. Kingman, Az. 86409
928-727-0737

Please note, if you so choose, you may complete this entire transaction by phone and the US Mail.

Once your application has been received and processed you will be contacted by an official from CAT who will conduct a short phone interview and relay instructions for participation, and set up a meeting. The following information is required to register:

Please complete all applicable fields then Submit at page bottom

Your Name:

Your E-Mail Address:

Confirm Your E-Mail Address:

Your Mailing Address:

Street Address if Different:

Apartment/Suite Number

City, State and Zip:

Number of years at current address:

If lesss than 1 year at current address, list previous

address:

Day Phone Number with Area Code:

Evening Phone Number with Area Code:
Where do you work:
Married or single:

Social Security Number (Optional but it will expedite your application)

Your Birth Date (This format: Month/Day/Year)
Height in feet and inches
Weight
Hair color: auburn, blond, brown, black, bald etc.
Eye color: blue, brown, black, hazel, green
Wear glasses, contacts or none
Vision, with corrective lenses: exp: 20/20 20/40 etc.
Do you smoke? Yes or No

Answer the next two questions carefully:

Are You Interested in a Lead Supervisory / Organizational Role/ or a position on the non-profit board?

Yes

Concealed Weapons Permit

Yes, I already have a Concealed Weapons Permit and am mailing it as advised above

No, I do not have a permit, I have paid my fee via PayPal.

Special Abilities:
(Please enter any abilities, or equipment you possess that may be of use to us. Examples include piloting, radio operator, former law enforcement, former military, computer experience, etc. Please list anything you think could help us in our fight.)

Submission time varies, please click only "once"