Badge Request Form (PRODUCTION)

You must login to the site before you can create a badge. If you are not logged in, we will not be able to assign you the badge requested.

What type of badge are you requesting? *

Select the Mazama Education Badge you are requesting

Select the Skill Badge you are requesting

Select the Leader Qualification Badge you are requesting 🛈

Select the non-Mazama Education Badge you are requesting

CPR: Valid for 1 or 2 years (look at the expiration date on your card)

BFA:Valid for 1 or 2 years (look at the expiration date on your card)

WFA & WFR: Valid for 2 years with a 1 year grace period

MoFA: Valid for 3 years

How did you earn the badge? Be specific and concise. For a Mazama class, include year and coordinator/leader.

0/200 characters

Please tell us a bit about how you earned this leadership qualification badge. Please be as specific as possible and attach documentation if you have it.

0/200 characters

Include a photo documentation if it was provided (a card, email confirmation of completion, etc ...)

Date Earned (summit date, class completion date, etc ... If uncertain, just guess; for BCEP or ICS enter 5/1 and then the year) * +

Expiration Date (if relevant) +

*Please note that it can take up to two weeks for badge requests to be processed