Renewal Application "*" indicates required fields Account Number*Company*Contact Person*Email* Phone*Address*Address Line 2City*State*Select a State…AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingZip Code*Vessel IDsRenewals ✓ Auto-Loading Your Information Company details and crew members are being loaded automatically. Select crew to renew below. ⚠️ Manual Entry Mode Enter crew member information manually below, or click here to auto-load from your account. Loading your crew members… Crew Members Available for Renewal Crew Members Selected: 0 🔄 Clear All ☑️ Select All Showing 0 of 0 crew members No crew members found. Total Number of Crew to RenewCrew to RenewNameSocial Security or MID Number Add RemoveCrew Members to AddEnter full name, Social Security Number (with dashes), date of birth, and pre-employment status for any new crewmembers that are to be added. If you mark a crewmembers as exempt, you must provide us with a negative DOT test dated within the last 6 months or a letter of compliance, on Company letterhead, dated within the last 30 days. Please email to info@drugfreevessel.com Note: Maritime ID Cards will be issued upon receipt of documentation of pre-employment status.Enter the number of crew who need a test in the box “Captain/Crew Members to Add” Drop Down boxes will appear below the line and you will enter the information on those lines.Captain/Crew Members to AddAdd Crew Members That Need a Test*NameSocial Security – Add DashesDate of BirthPre-EmploymentLicense Status ExemptNeeds TestQuick Crew SwitchLicensedUnlicensed Add RemoveRenewal FeeCaptains and Crewmembers RENEWED$75 per person. $85 in AK, HI, PR, VI. For Saipan and Guam $100 per person. Does not include any discounts. Price: QuantityCaptains and Crewmembers ADDED$75 per person. $85 in AK, HI, PR, VI. For Saipan and Guam $100 per person. Does not include any discounts. Price: QuantityPre-employment tests$60 per test, $70 in AK, GU, MP Price: QuantityConsortium HandbookContains USCG regulations Price: QuantityAdditional vessel stickersOne vessel sticker is included with the renewal of the company. Price: QuantityM-PAKs$20 per kit (covers one captain/crewmember (Mailed out within 2-3 weeks unless FEDEX is requested) See here for regulation Price: QuantityShipping Method*(Please specify shipping) Priority USPS Mail Fed Ex 2 Day USPS Priority Express Fed Ex Overnight Mon-Fri Fed Ex Sat Delivery Payment InformationTotalPayment Method* Visa Mastercard Amex Cardholder Name*Credit Card Number*Expires (mm/yyyy)*CCV*Required for Submission* I have read and agree to the 2026 renewal agreementPrinted on the back of my renewal form and hereAny special instructions when processing your application? Δ
