Fillable Printable The United States Army Recruiting Command Future Soldier Pre-execution Checklist
Fillable Printable The United States Army Recruiting Command Future Soldier Pre-execution Checklist
The United States Army Recruiting Command Future Soldier Pre-execution Checklist
Pass ph ysical fit ness assessmentPFA Training Schedule
Push-upsRepetitions:GoNo -Go
Sit-upsRepetitions:GoNo -Go
RunTime:GoNo -Go
Expirati on Date:
b. Used by the gui dance cou nselor, pers onnel officer , or adm i nist r at ive supp l y techni cian t o verify th at an appli cant has enl isted in the FSTP, RA, ARNG, or USAR.
THE UNITE D S TATES ARM Y RE CRUITING CO MMAND FUTURE SOL DIE R PRE- E XE CUTIO N CHECKLIST
DA Form 5500-R, Body Fat Cont ent Worksheet (M al e) or DA Form 5501- R, Body Fat Content Worksheet (Fem al e) ( i f appl i c able)
SF 1199A, Direct Deposit Si gn- Up Form (M ust h ave ATM car d or check book t o acc ess acc ount )
Estab lish Futu r e Sol dier Tr aini ng System ( FST S) account ( Futu r e Sol dier (FS) w i ll mai ntai n user name an d passwor d)
Marr i age Certi fic at e, Dependant Bir t h Certifi cat es (if app l icabl e)
Ot her su ppor t ing docum ents (FST S Dashboard, UF 1136 - Certifi cat e of T r ai ning, UF 1196 - SHARP Trai ning, et c)
Signature:
COMMANDING OFFICER'S TYPED NAME, RANK AND DATE:
Signature:
SECTION I V - P ROGRAM AND PROMOTI ON CERTIFICATION
I have reviewed the above FS's qualifications and hereby confirm and verify the readiness of this FS for Initial Military Training and all mandatory documents are present.
This is t o cert ify that t he FS has successfull y com pleted all Required Traini ng Tasks (BTTL), passed the Army Physical Fit ness Test ( APFT) wit h a score of 180 or above and provi ded a
qual i f i ed r ef err al that enlist ed i nto t he DEP, AR, RA or ARNG pri or to FS ship dat e. FS i s eligi ble for prom ot i on in accor dance wi t h AR 601-210, Chapter 2, Para 2- 18.
SECTION III - FUTURE SOLDIER ASSESSMENT SUMMARY
Fut ure Soldier Leader w i l l conduct a holistic assessm ent su m m ar y of th e FS with i n 30 day s of sh ippin g to In i t ial Mi litar y Tr ai ning ( IMT). Address t he FS's cur r ent stat us u si ng , but not l i m i ted to the follow i ng
focus ar eas:
1. Arm y Valu es
2. Training Competence
PRIVACY ACT STATEMENT
(For use of this form see USAREC Reg 601-95)
Fut ure Soldier LeaderDate Comp l eted
1. Name:
SECTION I - ORIENTATION TASKS
2. PRID:
6. RSID:
Cur rent and vali d Driver's Li cense or Stat e Identi fi cat i on Card
CENTER COMMANDER'S TYPED NAME, RANK A ND DA TE:
3. Beari ng ( ph ysical and emoti onal capabilit ies)
4. Leaders hip
5. Responsibility/Accountability (Family-Employer)
4. Ship Date:
5. FSL or Center Com mander:
3. MOS and Options:
EFFECT OF NO T P ROVIDING INFORM ATION: The di sclosur e of the informati on req uested i s enti rely volunt ar y. Failur e t o provide this information, however, may result in
PART I: REF ERRAL INFORM ATION
PART II: REFERRAL ENLISTMENT CERTI FICATION. Upon referr al enl i s t m ent, guidance couns el or w ill vali dat e r eferr al qu al i fi cat ions and update Part I of th is form wi th enlis t m ent date and br anch of
service in which th e r eferr al enli st ed. A ship date cert i fi cat ion w i ll b e m ade by the ship c ounsel or and signed in t he bl oc k bel ow.
Natu r al izat i on pac ket (N400 an d N426) (if app l icabl e)
Diploma / Transcripts (if applicable)
Estab lish Futu r e Sol dier Army Know l edge Online (AKO) account ( FS w i ll mai ntai n user name an d passwor d)
USAREC Form 1134 / 1134- 1- R (Un ited Stat es Arm y Futur e Soldier Tr aini ng Pr ogram ID Card)
SECTION I I - REQUIRED SHI P DOCUMENTS
SECTION V - ACTIVE ARMY AND RESERVE COM PONENTS REFERRAL SHEET
CERTIF ICATION OF GUIDANCE COUNSE LOR: I cer t i fy th at t he per sons identi fied i n Part I above are bona fide referral s of the per son identified in Bl ock I at the top of this page.
PRID:
NAME:
TELEPHONE:
ENLIST DATE AND BRANCH:
Register for ARS-SMART (www.futuresoldiers.com/html/referrals.jsp)
FS has al l item s on pac kin g li st (no m or e, no less)
informati on and t he effect of not providing inform at i on as discussed in th e Pr i vacy Act St at em ent ab ove.
a. Used b y the recruiter t o m ake con t act with a pr ospecti ve appli cant for enlis t m ent.
ROUTINE USES:
PRINCI PAL PURPOSE: To pr ovide su c h data as is r equest ed by a U. S. Arm y recruit er and/or gui dance cou nselor to cont act, p r ocess, and en l i s t prosp ects for Army s ervice.
AUTORITY: Coll ect i on of th e i nformation r equest ed and recorded on USAREC Form 1137, section IX, is aut horized b y Ti t le 10, USC, Section 513 3013(g)(3).
c. Used b y recr uiti ng person nel t o monit or t he Regular Arm y an d Reserve Components Referral Program and to formulate m ar ket dat a t o det er m i ne recruit i ng t r ends.
USAREC Form 1137, Rev 12 Nov 2013
denial of referral cr edit to appl icant or enli st ee m aking t he referral .
SPECIAL INSTRUCTIONS: Before collecting th e i nformation i n Part I below from prosp ective app lican ts for enl i s t m ent, you must i nform the pr os pective ap plic ants of th e uses for the
Printed Name, Ran k / G r adeSig nature an d Date
PREVIOUS EDIT IONS ARE OBSO LETE
V2.0
Page 1 of 2
Push-Up:
Sit-Up:
2-Mile Run:
DATE
YES/NO
30
390
420
DAYS
300
Resiliency Training Phase I
INITIAL *
30
60
Resiliency Training Phase III
Resiliency Training Phase II
Army Sui ci de Pr event ion- ACE
330
360
270
90
120
180
210
240
Repet i t ions / Scor e
120
150
180
SHARP / Un auth or i zed Relationships
240
270
150
* Place t he date t hat init i al trai ning occurs
WK3
WK4
WK6
WK7
WK8
WK9
TIME IN DEP
(Mark the block t hat dictates the FS Tim e in DEP)
Subj ec t
1st Sem
FS Orient
30
60
90
120
RENEGOTIATION
Credits
Req for
Grad
Grades
D or F
REASON
1-Sem
Credits
300
330
360
390
210
SECTION VI - LEADER BASE D TRAINING
* Place t he date t hat init i al trai ning occurs
420
60
90
DAYS
INITIAL *
30
DAYS
INITIAL *
30
60
90
120
150
180
210
240
270
300
330
360
390
420
SECTION VIII - ADDITIONAL TRAINING
Combat Trafficking in Persons (CTIP)
360
WK11
INITIAL
60
90
420
150
Female Waist M easurement
Female Hi p Measu r em ent
Female BFM
HT / WT (BFM Weekl y)
APFT SCO RE
WK24
WK25
WK26
WK27
WK28
Mal e BFM
Female Neck Measu r em ent
Female Waist M easurement
Repet i t ions / Scor e
Repet i t ions / Scor e
DATE
270
120
HT / WT ( Monthl y)
HT / WT (BFM Weekl y)
Mal e Neck M easurement
Mal e Waist Measurement
Mal e BFM
Female Neck Measu r em ent
Physical
WK1
WK2
120
150
180
210
240
270
300
330
WK5
WK20
DAYS
(Diagnostic APFT will be administered Monthly to each Future Soldier)
WK22
WK23
Female Hi p Measu r em ent
Female BFM
Physical
WK15
WK16
Mal e Neck M easurement
Mal e Waist Measurement
WK19
WK18
240
210
240
SECTION X - DIAGNOSTIC APFT
WK17
Subj ec t
1st Sem
Subj ec t
2nd Sem
Subj ec t
2nd Sem
WK21
Days
Absent
ABSENT
1st Sem
ABSENT
2nd Sem
420
300
390
390
180
300
330
360
270
150
180
210
SECTION XI - LIFESTYLE INVENTORY
330
360
WK12
WK13
WK14
420
WK10
390
SECTION IX - HEIGHT / WEIGHT
60
90
Physical
30
Army Valu es and Histor y
Dril l and Cerem onies
* Place t he date t hat init i al trai ning occurs
2-Sem
Credits
Subj ec t
1st Sem
Subj ec t
2nd Sem
YES/NO
TYPE
IN-DEP M E DICAL
DATE
SECTION VII - REQUIRED TRAINING (BTTL)
Anti-Terrorism
First Aid
General O r der s
Land Navig ation
Cust om s, Courtesi es , Tradit i ons
Military Time
Phonetic Alphabet
PREVIOUS EDIT IONS ARE OBSO LETE
V2.0
Page 2 of 2
USAREC Form 1137, Rev 12 Nov 2013
SCHOOL INFORMATION
Rank Structure
Voice Commun i cat ion
Equal Opportunity
Equipment of the US Army
Person al Recovery
Risk Assessmen t
