DEPARTMENT OF HOMELAND SECURITY 

U.S. Coast Guard OMB Control No. 1625-New 

COAST GUARD ART PROGRAM (COGAP) Exp Date: mm/dd/yyyy 

Membership Application Form 

This application form must be approved by the Coast Guard. Accompanying samples of work are subject to 

the approval of the Coast Guard and the COGAP Membership Chair of the Salmagundi Club, COGAP’s 

cosponsor. 

Please complete the second page of this form and submit it along with low resolutions jpeg files of your work 

to: 

Mary Ann Bader 

COGAP Coordinator 

Maryann.bader@uscg.mil 

Phone: 202-372-4643 

If you prefer, you can also mail this form and samples of your work to: 

Mary Ann Bader 

CG Headquarters, CG-09232 

2703 Martin Luther King, Jr., Ave., S.E., Stop 7301 

Washington, D.C. 20593-7301 

For more information on COGAP visit www.uscg.mil/Community/Art-Program/ 

The Salmagundi Club, COGAP’s cosponsor is located at 47 Fifth Avenue, New York, N.Y. Karen Loew is 

the COGAP Committee Chair and Tom Hedderich is the COGAP Membership Chair. For more information 

on the club visit www.salmagundi.org 

“We immortalize in our paintings and drawings those who serve our country in the U.S. Coast Guard.” 

Karen Loew 

Privacy Act Statement 

Authority: 5 U.S.C. §301, Departmental regulations; 14 U.S.C. §§93(a)(6), Commandant general powers; and 44 U.S.C. §3101, Records 

management by agency heads. 

Purpose: The Coast Guard Art Program (COGAP) uses fine art as an outreach tool for educating diverse audiences about the United States Coast 

Guard (USCG). This application is used by individuals seeking membership in COGAP. 

Routine Uses: Authorized USCG personnel will utilize this information to determine if an applicant has the necessary ability to qualify for 

membership. Any external disclosures of data within this record will be made in accordance with DHS/ALL-027, The History of the Department of 

Homeland Security, 75 Federal Register 8092, February 23, 2010. 

CONSEQUENCES OF FAILURE TO PROVIDE INFORMATION: Application for membership is voluntary. However, individuals must complete 

this application and submit samples of work for membership consideration. 

An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a valid OMB control 

number. The Coast Guard estimates that the average burden per response for this report is about 30 minutes. You may submit any comments 

concerning the accuracy of this burden estimate or any suggestions for reducing the burden to: COGAP Coordinator, CG-09232, 2703 Martin 

Luther King Jr. Ave., SE, Stop 7103 Washington, DC 20593-7103, or Office of Management and Budget, Paperwork Reduction Project (1625-new), 

Washington, DC 20503. 

CG-5700 (01/19) 
 

 

DEPARTMENT OF HOMELAND SECURITY 

U.S. Coast Guard OMB Control No. 1625-New 

COAST GUARD ART PROGRAM (COGAP) Exp Date: mm/dd/yyyy 

Membership Application 

Membership is open to artists working in media that create one of kind pieces of work, such as paintings 

and drawings. Media producing multiple images such as photography, computer-generated images, and 

printmaking, and three dimensional work such as sculpture are not accepted. Previous experience in 

maritime painting is not required. 

Please submit this form with low resolution jpeg files of your work to Mary Ann Bader, COGAP Coordinator 

at Maryann.bader@uscg.mil. The quality of your work is an important factor in acceptance into the 

program; therefore, please choose your samples carefully. You can also submit by mailing this form and 

images of your work to Mary Ann Bader, Coast Guard Headquarters, CG-09232, 2703 Martin Luther King 

Jr. Ave., SE, Stop 7103 Washington, DC 20593-7103. Artist members in good standing of the Salmagundi 

Club need not send samples. They must, however, complete this application form. 

Annually in January, member artists submit samples of work to be considered for acceptance into the 

permanent collection. The Salmagundi Club's Excellence Committee reviews these samples to determine 

which ones will be accepted. Representational works of high artistic merit as well accuracy in depicting 

Coast Guard missions and people are sought for the collection. COGAP members are requested to submit 

new artwork for review annually if possible and no less than once every three years. If a COGAP member 

is having difficulty submitting artwork within the three-year time frame, they are asked to contact Coast 

Guard Community Relations at 202/372-4643. All accepted art becomes the property of the U. S. Coast 

Guard. Artists relinquish all copyrights. 

Thank you for your interest in the Coast Guard Art Program. 

NAME 

ADDRESS 

CITY STATE ZIP 

EMAIL ADDRESS WEBSITE 

DAYTIME PHONE EVENING PHONE CELL PHONE 

PLACE OF BIRTH DATE OF BIRTH 

ART EDUCATION 

QUALIFICATIONS AND EXPERIENCE (use a separate sheet if necessary) 

DATE APPLICANT'S 

SIGNATURE 

CG-5700 (01/19)