AMO Registration Form

Entries with "*" are required.

You must be "Fit for Duty" to attend STAR Center classes.

1Personal Information > 2Course Information > 3Lodging > 4Review & Submit
Name: Name: First Last
Please enter your first and last name.
*This field is required.
Email Address

Please enter the e-mail address you want us to use as we move through the registration process.
SSN - LAST 4 ONLY (Required for our ID purposes)
Must be a number less than or equal to 9999.
Please enter the LAST 4 digits of your SSN as we need it to match up your records.
Mariner Reference Number

From your Merchant Mariner Credential
Primary Contact Phone #:

Please enter the primary phone number we can reach you at.

Do not insert dashes.
Alternate Phone #:

No dashes!
Address that you will be at immediately prior to coming to STAR Center: Address that you will be at immediately prior to coming to STAR Center:
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Please enter your address information.
AMO Member Book / Applicant #:

Please enter your AMO book or applicant number.
License (e.g. 2nd Mate, 3 A/E etc.)

Please show your highest license, not what you may be sailing.
Present (or last) Ship:
Are you currently assigned to a vessel sailing under Military Sealift Command operational control?

Are you currently assigned to a vessel sailing under Military Sealift Command operational control? NO YES
Present (or last) Company:
Date Assigned: Date Assigned: / MM / DD YYYY
Expected(or last) Discharge Date: Expected(or last) Discharge Date: / MM / DD YYYY