Membership Application

Membership Level: First Name: Last Name: Current Military Unit | Current Public Safety Agency | or Employer Email: Email 2: Some government servers reject our emails, please provide an alternate personal email address Address: City: 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 American Samoa Federated States of Micronesia Guam Marshall Islands Northern Mariana Islands Palau Puerto Rico U.S. Minor Outlying Islands Virgin Islands Armed Forces Americas Armed Forces Europe, the Middle East, an Armed Forces Pacific Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Nova Scotia Northwest Territories Nunavut Territory Ontario Prince Edward Island Quebec Saskatchewan Yukon Territory Zip: - Zip Suffix Phone: Currently active EOD or on an accredited Public Safety Bomb Squad? (Put n/a if not applicable) NO YES N/A EOD School: HDS Redstone Arsenal Naval School EOD Other n/a HDS Class Number: EOD Class Number or Graduation Date: Specify other EOD school: If applying as former military EOD or Public Safety Bomb Tech, please email a copy of a certificate of completion from NAVSCOLEOD or HDS to info@usbta.us within 10 days of applying If Military, Immediate Supervisor's Name | If Public Safety, Bomb Squad Commander's Name (if Applicable): Military Supervisor | Bomb Squad Commander's Email (If Applicable): Military Supervisor | Bomb Squad Commander's Phone Number (If Applicable): Captcha