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Get Fort Hood 7023 2012-2024

14a. PRINTED NAME OF INSTALLATION SECURITY DIVISION REPRESENTATIVE FORT HOOD FORM 7023 SEPTEMBER 2012 14b. FORT HOOD SECURITY MANAGERS TRAINING COURSE SMTC REGISTRATION For use of this form see AR 380-5. The proponent is DPTMS* PRIVACY ACT STATEMENT AUTHORITY EO9397 EO10450 EO10865 EO12968 EO12333 PRINCIPAL PURPOSE S The requested information is for the purpose of registering individuals to attend the Security Managers Training Course SMTC and to verify required access for the course. ROUTINE USES Used for registering student to attend the SMTC. DISCLOSURE Voluntary including DOD ID number. However attendance may not be granted if all requested information is not provided* SECTION l - USER INFORMATION 1. LAST NAME 2. FIRST NAME 3. MIDDLE NAME 4. DOD ID NUMBER 5. GRADE / RANK 6. ORGANIZATION NAME 7. JOB TITLE 8. DUTY TELEPHONE NUMBER 9. DUTY E-MAIL SECTION ll - COURSE REQUIREMENTS 10. REQUIREMENTS COPIES OF CERTIFICATES REQUIRED PERSONALLY IDENTIFIABLE INFORMATION PII TRAINING COMPLETED ON SECURITY POLICIES PRINCIPLES AND PROGRAMS GS140-16 COMPLETED ON STORAGE CONTAINERS AND FACILITIES PY 105-16 COMPLETED ON DEVELOPING A SECURITY EDUCATION AND TRAINING PROGRAM GS104. 16 COMPLETED ON MARKING CLASSIFIED INFORMATION IF 105-16 COMPLETED ON APPOINTMENT ORDERS SIGNED ON PROVIDE A COPY 11. REGISTER FOR COURSE SECTION lll - NOMINATING OFFICIAL 12. NOMINATING OFFICIAL S CERTIFICATION I CERTIFY THE ABOVE NAMED INDIVIDUAL MEETS REQUIREMENTS FOR ATTENDING THE SECURITY MANAGERS TRAINING COURSE SMTC. THIS INDIVIDUAL HAS COMPLETED REQUIRED TRAINING BY THE METHOD AND ON THE DATE INDICATED ABOVE* I CERTIFY THE NAMED USER REQUIRES THIS COURSE IN ORDER TO PERFORM ASSIGNED DUTIES* DATE SECTION lV - STUDENT 13. STUDENT AGREEMENT I UNDERSTAND I AM RESPONSIBLE FOR COMPLETING THE SMTC 40-HOUR COURSE TO OBTAIN A CERTIFICATE OF COMPLETION* 13a* USER S PRINTED NAME 13b. USER SIGNATURE SECTION V - INSTALLATION SECURITY DIVISION ONLY 14. VALIDATING OFFICIAL I VERIFIED THE JPAS AND THE INDIVIDUAL MEETS MINIMUM INVESTIGATIVE AND CLEARANCE ELIGIBILITY REQUIREMENTS TO ATTEND THE SMTC. FORT HOOD SECURITY MANAGERS TRAINING COURSE SMTC REGISTRATION For use of this form see AR 380-5. The proponent is DPTMS* PRIVACY ACT STATEMENT AUTHORITY EO9397 EO10450 EO10865 EO12968 EO12333 PRINCIPAL PURPOSE S The requested information is for the purpose of registering individuals to attend the Security Managers Training Course SMTC and to verify required access for the course. ROUTINE USES Used for registering student to attend the SMTC. DISCLOSURE Voluntary including DOD ID number. ROUTINE USES Used for registering student to attend the SMTC. DISCLOSURE Voluntary including DOD ID number. However attendance may not be granted if all requested information is not provided* SECTION l - USER INFORMATION 1. However attendance may not be granted if all requested information is not provided* SECTION l - USER INFORMATION 1. LAST NAME 2. FIRST NAME 3. MIDDLE NAME 4. DOD ID NUMBER 5. GRADE / RANK 6. ORGANIZATION NAME 7. JOB TITLE 8. .

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