Leader Development Applicaton

TITLE 10 ADOS ENLISTED APPLICATION CHECKLIST Do NOT Submit an Incomplete Packet

LAST NAME ______FIRST NAME______MI______RANK ______SSN ______PMOS______STATE______BASD______CURRENT STATUS (circle one): M-Day T-32 T-10 ADOS Mil Tech Other______EMAIL ADDRESS______PHONE______PACKET SEQUENCE: Incomplete packets will be returned

Tab Requirement

A ______NGB Form 34-1, Application for AGR Position (GKO) earlier version(2010)

B ______AGR Tour Agreement w/LETTERHEAD (GKO)

C ______Tour Assignment Preference Statement (GKO)

D ______ERB certified or DA Form 2-1 - Certified Copy and signed by applicant

E ______DA Photo (within last 12 months) dated

F ______Last 3 years consecutive NCOERs (Profiled)

G ______DA FORM 705: Last three years of APFT scores, most recent within 8 months. (1) ______DA Form 5500/1-R, Body Fat Content Worksheet for every APFT (if applicable) (2) ______DA Form 3349, Physical Profile (if applicable)

H ______Individual Medical Readiness (IMR) Record Printout (AKO) (Forms) (IMR Record) (Dates of Physical Exam & HIV must be within 2 years if not submit a PHA dated Within 1 year) Excel Spreadsheet

I ______NGB Form 23b, RPAM (within 3 months)

J ______DA Form 1172, DEERS Enrollment (signed by applicant and certified official)

K ______SEL / State CSM / Recommendation Letter

L ______Security Clearance Memo from your Security Manager

M ______Army/American Registry Transcript System (AARTS) highest school completed

N ______DA 4836 Oath of Extension of Enlistment or DD 4 Series Enlistment Contract

O ______Civilian Education; all transcripts (photocopies accepted)

P ______DD 214s (If applicable)

22 APRIL 2014