4137 Air Assault Details

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QuestionAnswer
Form NameFc Form 4137
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other namesfc4137, army 4137 form, fc 4137, form 4137 air assault

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CLASS ENROLLMENT - AIR ASSAULT SCHOOL COURSES

(For use of this form see CAM Circular 351-1. The proponent of this form is G3/DPTMS/TAAS)

CLASS REQUESTED (CIRCLE ONE)

 

 

BASIC AIR ASSAULT

RAPPEL MASTER

IRT

 

 

 

PATHFINDER

FRIES/SPIES MASTER

PRE-RANGER

 

 

 

 

 

 

 

 

 

 

 

 

 

SECTION I - PERSONNEL INFORMATION

 

 

1.

NAME (Last, First, MI)

 

2. RANK

3. SEX (circle one)

 

 

 

 

 

 

 

 

MALE FEMALE

 

 

 

 

 

 

 

 

 

 

4.

SSN

 

5. MOS

6. AGE

7. DUTY POSITION

8. UIC

 

 

 

 

 

 

 

 

 

9.

UNIT (Co, Bn, BCT, Installation and Zip)

 

 

 

 

10. CLASS #

11.MUST HAVE TWO TELEPHONE NUMBERS FOR EMERGENCIES

UNIT:SUPERVISOR:

SECTION II - PRE-REQUISITES

12. The above mentioned Soldier meets the folowing pre-requisites:

 

DATE (YYYYMMDD)

INITIALS

 

 

 

 

TL / SL

SOLDIER

 

 

 

 

 

 

 

a. MEET HEIGHT/WEIGHT STANDARDS, IAW AR 600-9 (Attach DA Form 5500/5501, if needed).

 

 

 

 

 

 

b. SUCCESSFULLY COMPLETE THE APFT, IAW FM 21-20 (within 30 days).

 

 

 

 

 

 

 

 

 

 

c. COMPLETE 12 MILE FOOT MARCH (within 90 days).

 

 

 

 

 

 

 

 

 

 

 

d. COMPLETE OBSTACLE COURSE (within 60 days).

 

 

 

 

 

 

 

 

 

 

 

e. EQUIPMENT INSPECTION (within 30 days).

 

 

 

 

 

 

 

 

 

 

 

f. 12 MONTH RETAINABILITY.

 

 

 

 

 

 

 

 

 

 

g. SOLDIER HAS ASSIGNED WEAPON (IRT only). (CIRCLE ONE)

M16

M4

M9

 

h.ROPER QUALIFIED IAW USASOC 350-6 (for SPIES/FRIES Master only).

i.AIR ASSAULT QUALIFIED (for Pathfinder, Rappel Master & SPIES/FRIES Master only).

j.CURRENT PHYSICAL (Pathfinder, Pre-Ranger & Soldiers over 40 only).

k. PRE-RANGER MODIFIED APFT: PU-49, SU-59, 5MR-40 mins or less (Pre-Ranger

CHIN UPS

 

only).

 

 

 

l. CWST: 15m SWIM, 3m DROP, EQUIPMENT REMOVAL (Pre-Ranger only).

 

 

 

m. LAND NAVIGATION COURSE (Pre-Ranger only).

 

SECTION III - REMARKS

13.

SECTION IV - APPROVAL/SIGNATURES

14.

SUPERVISOR

15.

SUPERVISOR SIGNATURE

16.

DATE (YYYYMMDD)

 

 

 

 

 

 

17.

COMMANDER/FIRST SERGEANT

18.

CDR/1SG SIGNATURE

19.

DATE (YYYYMMDD)

 

 

 

 

FC FORM 4137, AUG 2007

(FC FORM 4137, SEP 2006, IS OBSOLETE)

 

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