VP 26 Reenlistment Request1 by HC120501031125

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									APPROVAL ROUTING

REENLISTING OFFICER               _______________________________ DATE:_____________ YES: ____ NO: ____

ARGUS (ACCESS AT HTTPS://WWW.BOL.NAVY.MIL ) COMPLETE ,PRINT, ADD TO FOLDER            DATE: _____________

DIVISIONAL CAREER COUNSELOR: _______________________________ DATE:_____________ YES: ____ NO: ____

LEADING PETTY OFFICER:            _______________________________ DATE:_____________ YES: ____ NO: ____

LEADING CHIEF PETTY OFFICER:      ________________________________DATE: ____________ YES: ____ NO: ____

DIVISION OFFICER:                 _______________________________ DATE:_____________ YES: ____ NO: ____

MEDICAL:                          _______________________________ DATE:_____________ YES: ____ NO: ____

COMMAND FITNESS COORDINATOR _______________________________ DATE: _____________ YES: ____ NO: ____

DEPARTMENT HEAD:                  _______________________________ DATE:_____________ YES: ____ NO: ____

PERSONNEL OFFICER:                _______________________________ DATE:_____________ YES: ____ NO: ____

COMMAND CAREER COUNSELOR:         _______________________________ DATE:______ELIGIBLE      Y/ N

COMMAND MASTER CHIEF:             _______________________________ DATE:_____________ YES: ____ NO: ____

EXECUTIVE OFFICER:                _______________________________ DATE:_____________ YES: ____ NO: ____

COMMANDING OFFICER:               _______________________________ DATE:_____________ YES: ____ NO: ____



REASON FOR DISAPPROVAL: (COMMANDING OFFICER USE ONLY)



____________________________________________________________________________________________________________

____________________________________________________________________________________________________________
                          VP-26
      REENLISTMENT INTERVIEW & APPLICATION REQUEST

  DEPARTMENT/DIVISION COUNSELOR WILL VERIFY ALL INFORMATION CONTAINED HEREIN:

  NAME: ___________________________________ LAST 4 SSN:_______ RATE: _______ DESG(AW/NAC/SW):________

  BRANCH OF SERVICE: USN / USNR / USNR (FTS)         HOME OF RECORD: CITY__________________ STATE_______

  DATES: (USE DD/MM/YY)         EAOS:__ _/ ___/_   __ ADSD: _ __/_ __/_ __ HYT: __ _/_ __/_ __


  DATE OF REENLISTMENT: __________________          ______   REENLISTMNET TERM: YEARS 2, 3, 4, 5, 6

  REENLISTING FOR: ____ BENEFITS OF RATE, _____ SRB, ____ STAR, ____ SCORE, ____ GUARD 2000

  IS MEMBER REQUESTING A “C” SCHOOL INCENTIVE FOR REENLISTING? YES / NO

  COURSE TITLE: _________________________________________ COURSE NUMBER: __________________ NEC: ________

  SELECTIVE REENLISTMENT BONUS (SRB) INFORMATION:

  SRB ELIGIBLE: YES / NO        QUALIFYING SRB RATE/NEC: ____________

  RE-UP OFFICER: ____________      _____________ RANK: ______ TITLE ( AO, MMCO, Divo, etc):__________________

  PLACE OF REENLISTMENT: ___________________________________________________ Time _________
                         (Place/City/State or Where in Hanger)


  LEAVE INFORMATION: Days selling back ______ ( Max 60 per career )   DAYS PREVIOUSLY SOLD: ___________

  MEDICAL INFORMATION:                 MEMBERS MEDICAL RECORD SCREEN ELIGIBLE:         YES / NO
                                       PHYSICAL SCHEDULED:                             YES / NO
  MEMBER MEETS PRT STANDARDS: PFA’S FAILED IN LAST 4 YEARS: ____________
  GENERAL REMARKS:

  SPOUSE: _____________________________________

  CHILDREN: __________________,__________________,__________________,__________________,__________________,

  UNIFORM FOR REENLISTMENT: _____________________________________________

  FHTN RELEASE: Y/N           PHOTO: Y/N             CAKE: Y/N                 PLAQUE: Y/N

I UNDERSTAND I CAN ONLY SELL BACK A TOTAL OF 60 DAYS LEAVE DURING MY CAREER. I UNDERSTAND I MAY
HAVE TO PAY BACK ANY UNEARNED PORTION OF MY SRB IF I AM SUBSEQUENTLY INVOLUNTARILY OR
VOLUNTARILY (EARLY-OUT) DISCHARGED FROM ACTIVE DUTY PRIOR TO MY EAOS. I UNDERSTAND THAT I AM
PERSONALLY RESPONSIBLE FOR ATTAINING WRITTEN MEDICAL CONFIRMATION OF MY ELIGIBILITY FOR
REENLISTING OR MY REENLISTMENT WILL BE POSTPONED. I UNDERSTAND THAT MY REQUEST MUST BE ROUTED,
APPROVED BY MY CHAIN OF COMMAND AND RECEIVED BY THE CCC NO LATER THAN 30 WORKING DAYS (45
WORKING DAYS FOR SRB REENLISTMENTS) PRIOR TO MY REQUESTED REENLISTMENT DATE PER LOCAL JFTR. I
UNDERSTAND I WILL PERSONALLY VERIFY ALL DOCUMENTS WITH THE CCC WITHIN 24 HOURS OF MY
REENLISTMENT. I UNDERSTAND THIS STATEMENT AND THAT ALL THE ABOVE INFORMATION IS CORRECT TO THE
BEST OF MY KNOWLEDGE.

MEMBER SIGNATURE: ___________________________________________________ DATE:_______________________

								
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