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Get Enrollment Fort Hood 2015-2024

ENCLOSURE 2 PWA ENROLLMENT FORM TO OPERATION ORDER PW 15-09-0858 PHANTOM WARRIOR ACADEMY FORT HOOD AIR ASSAULT SCHOOL PHANTOM WARRIOR ACADEMY ENROLLMENT FORM The proponent of this form is G3 CLASS REQUESTED circle one AIR ASSAULT COMBAT LEADERS COURSE SECTION I PERSONNEL INFORMATION 1. NAME Last First MI 4. SSN 2. RANK 5. MOS 6. AGE 7. DUTY POSITION 3. SEX circle one MALE FEMALE 8. UIC 9. UNIT Co Bn BCT Installation and Zip 10. CLASS 11. MUST HAVE TWO TELEPHONE NUMBERS FOR EMERGENCIES UNIT 1SG SUPERVISOR SECTION II PRE-REQUISITES 12. The above mentioned Soldier meets the following pre-requisites DATE YYYYMMDD INITIALS TL/SL a* MEET HEIGHT/WEIGH STANDARDS IAW AR 600-9 ATTACH DA Form 5500/5501 if needed. b. c* SUCCESSFULLY COMPLETE THE APFT IAW TC-3-22. 20 within 30 days. COMPLETED A 4 MILE RUN IN UNDER 35 MINUTES* Within 30 days of course start date d. COMPLETE 12 MILE FOOT MARCH IN LESS THAN 3hours with AA packing list Within 90 days FOR AIR ASSAULT STUDENTS* CLC WILL COMPLETE WITH A 30-35 LB RUCK SACK. e. COMPLETE OBSTACLE COURSE Tough One Swing Stop Jump Belly Crawl Confidence Climb Incline Wall Low Belly Over Weaver High Step Over Six Vaults Within 60 days. COMBAT LEADERS COURSE CANDIDATES MUST ALSO COMPLETE TARZAN TOUGH NUT AND SLIDE FOR LIFE IN ADDITION TO THE AIR ASSAULT NINE OBSTACLES* f* EQUIPMENT INSPECTION Within 30 days. g. UNIT S PHYSICIANS ASSITANT HAS REVIEWED SOLDIER S MEDICAL HISTORY AND HAS SIGNED A COPY OF THE MEDICAL CLEARENCE MEMORANDUM NO EARLIER THAN 90 DAYS PRIOR TO COURSE STATE DATE* h. 12 MONTH RETAINABILITY. N/A SOLDIER SECTION III REMARKS SECTION IV APPROVAL/SIGNATURES 15. SUPERVISOR SIGNATURE 17. COMMANDER/FIRST SERGEANT 18. CDR/1SG SIGNATURE 20. BC / SCO FIRST O5 IN CHAIN OF COMMAND 21. BC / SCO SIGNATURE SEPTEMBER 2015 Page 1 of 1 V1. NAME Last First MI 4. SSN 2. RANK 5. MOS 6. AGE 7. DUTY POSITION 3. SEX circle one MALE FEMALE 8. UIC 9. UNIT Co Bn BCT Installation and Zip 10. CLASS 11. MUST HAVE TWO TELEPHONE NUMBERS FOR EMERGENCIES UNIT 1SG SUPERVISOR SECTION II PRE-REQUISITES 12. UNIT Co Bn BCT Installation and Zip 10. CLASS 11. MUST HAVE TWO TELEPHONE NUMBERS FOR EMERGENCIES UNIT 1SG SUPERVISOR SECTION II PRE-REQUISITES 12. The above mentioned Soldier meets the following pre-requisites DATE YYYYMMDD INITIALS TL/SL a* MEET HEIGHT/WEIGH STANDARDS IAW AR 600-9 ATTACH DA Form 5500/5501 if needed. The above mentioned Soldier meets the following pre-requisites DATE YYYYMMDD INITIALS TL/SL a* MEET HEIGHT/WEIGH STANDARDS IAW AR 600-9 ATTACH DA Form 5500/5501 if needed. b. c* SUCCESSFULLY COMPLETE THE APFT IAW TC-3-22. 20 within 30 days. COMPLETED A 4 MILE RUN IN UNDER 35 MINUTES* Within 30 days of course start date d. b. c* SUCCESSFULLY COMPLETE THE APFT IAW TC-3-22. 20 within 30 days. COMPLETED A 4 MILE RUN IN UNDER 35 MINUTES* Within 30 days of course start date d. COMPLETE 12 MILE FOOT MARCH IN LESS THAN 3hours with AA packing list Within 90 days FOR AIR ASSAULT STUDENTS* CLC WILL COMPLETE WITH A 30-35 LB RUCK SACK.

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