D11NR Form 7023w

Notice of Intent to Teach Public Education Course

Instructions:

Enter your course's details in the form below.

This information will be forwarded by your DSO-PE to BoatU.S. and other media.

The disclosure of a member's personal information is generally prohibited under the Privacy Act of 1974 UNLESS express permission is obtained from the member. All persons whose names and contact information are utilized in the connection with this form expressly authorize the dissemination and publication of the information to members of the general public. The person completing this form acknowledges that the appropriate permissions have been obtained.