Get DA 3838 2007

NAME GRADE BRANCH AND TITLE DA FORM 3838 SEP 2007 I DO NOT RECOMMEND APPROVAL 27. SIGNATURE Local Approving Authority EDITION OF NOV 1982 IS OBSOLETE. APD LC v1. DATE APPLICATION FOR SHORT COURSE TRAINING For use of this form see AR 351-3 the proponent agency is the Office of The Surgeon General PRIVACY ACT STATEMENT 1. AUTHORITY 10 USC Section 3013 Secretary of the Army AR 351-3 Professional Education and Training Programs of the Army Medical Department and E* O. 9397 SSN. 2. PRINCIPAL PURPOSE S To obtain data needed to determine eligibility for enrollment process applications maintain student records and to perform all other administrative functions inherent in student administration* 3. ROUTINE USES None. The Blanket Routine Uses set forth at the beginning of the Army s Compilations of System of Records Notices apply to this system* 4. MANDATORY OR VOLUNTARY DISCLOSURE Voluntary. However failure to provide the requested information may result in the applicant not being able to participate in the program* TO FROM 1. NAME Individual Requesting Training 2. SSN I. GENERAL INFORMATION 4. SECURITY 3. RANK CLEARANCE 8. UIC 7. UNIT AND STATION Address and Zip Code 9. DUTY POSITION 5. CORPS/ BRANCH 6. MOS/AOC 10. CATEGORY OF SERVICE REGULAR ARMY RESERVE 11. OFFICE PHONE 12. OFFICE FAX 13. HOME PHONE Include area code and DSN 14. AKO E-MAIL ADDRESS II. TRAINING INFORMATION 15. TYPE OF FACILITY SPONSORING TRAINING Check applicable box 16. DATES OF COURSE EXCLUDING 17. PROFESSIONAL LICENSE TRAVEL TIME Day Month Year List any required for requested CIVILIAN INSTITUTION non-Federal course FEDERAL FACILITY AMEDD ARMY Less AMEDD OTHER MILITARY Air Force Navy etc* NON-MILITARY PHS VA etc* 18. NAME OF COURSE REQUESTED Attach copy of course brochure 19. LOCATION OF COURSE Include address and zip code 20. LIST COSTS AS APPLICABLE REGISTRATION TUITION OTHER 21. COURSES TAKEN Include courses in both federal facilities and civilian institutions that have been taken during the current year and prior fiscal year. Include source of funding e*g* local AC OTSG and AMEDD C S Central Training Program* If none so indicate 22. DATE OF MOST RECENT CBRNE TRAINING 23. SIGNATURE Applicant 24. DATE III. TRAINING APPROVAL 25. LOCAL APPROVING AUTHORITY Check appropriate box and add remarks if applicable I RECOMMEND APPROVAL 26. DATE APPLICATION FOR SHORT COURSE TRAINING For use of this form see AR 351-3 the proponent agency is the Office of The Surgeon General PRIVACY ACT STATEMENT 1. AUTHORITY 10 USC Section 3013 Secretary of the Army AR 351-3 Professional Education and Training Programs of the Army Medical Department and E* O. AUTHORITY 10 USC Section 3013 Secretary of the Army AR 351-3 Professional Education and Training Programs of the Army Medical Department and E* O. 9397 SSN. 2. PRINCIPAL PURPOSE S To obtain data needed to determine eligibility for enrollment process applications maintain student records and to perform all other administrative functions inherent in student administration* 3. .