Form Navcruit 1131 16 PDF Details

The Navcruit 1131/16 form serves a crucial role in managing the careers of individuals in the Navy's medical programs, encapsulating both their duty preferences and personal information under the umbrella of the Privacy Act. Authorized under the Department of Regulations and Executive Order 9397, the form's primary purpose is to streamline the administration and operation of personnel affairs within the Navy. It assists Department of Navy officials in making informed decisions about qualifications and suitability for future assignments, with an emphasis on matching individuals to their preferred duty stations. Applicants are required to detail personal information, including name, contact details, and professional background, alongside their duty station preferences. Participation in the process is voluntary, but failing to provide the requested information may result in an assignment without considering one's preferences. Additional sections cater to verifying educational background, professional licenses, and marital status, ensuring a comprehensive overview for NAVCRUITDIST and NAVMEDCOM/NAVCRUITCOM personnel. This intricate procedure not only allows for a tailored approach to future assignments but also emphasizes the Navy's commitment to respecting and protecting the privacy of its personnel.

QuestionAnswer
Form NameForm Navcruit 1131 16
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other namesNCP Duty Preference form NAVCRUIT 1131_16 navy ncp form

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DUTY PREFERENCE FOR MEDICAL PROGRAMS

Privacy Act Statement

AUTHORITY AND PURPOSE: 5 U.S.C. 301, Departmental Regulations; and E.O. 9397(SSN). Provided information is used to assist officials and employees of the Navy in the management, supervision and administration of Navy personnel (officer and enlisted) and the operations of related personnel affairs and functions.

ROUTINE USES: Information will be utilized by Department of the Navy officials in verifying qualifications and suitability for future assignments. Contact information may also be provided to applicable personnel as it relates to your established future duty stations.

DISCLOSURE: Voluntary. However, failure to provide the requested information may result in an administrative assignment to future duty without your preference.

To be completed by Applicant

Name: (Last Name, First Name, Middle Initial)

DOB (dd/mm/yyyy)

Gender:

Male

Female

Email:

 

 

 

 

Home Phone

 

Work Phone

 

 

 

 

 

 

 

 

 

 

 

 

 

Collocation With Aactive Duty Spouse Requested:

 

 

 

Yes

 

No

 

N/A

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Is Buddy System Requested?

 

Yes

 

 

No

If yes to the question above or this question, please provide the following information:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Name: (Last Name, First Name, Middle Initial)

Rank.and Corps:

Duty Station:

Detailer's Name:

Telephone Number:

Duty Preferences:

1.

2.

3.

OIS Class (dd/mm/yyyy)

To be completed by NAVCRUITDIST personnel

NAVCRUITDIST:

UIC:

Recruiter:

Telephone Number:

 

 

Please provide the following Applicant information:

Home of Record with Zip Code:

Mailing Address with Zip Code:

Education Level (Yrs):

 

 

 

 

 

 

 

 

 

Graduation Date (dd/mm/yyyy):

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Current License:

 

Yes

 

 

 

No

 

 

 

 

B.D. Cert. Date (dd/mm/yyyy):

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Current Pending License:

 

 

Yes

 

No

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Active Service?

 

Yes

 

 

 

No

 

 

 

Prior

 

Current

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

If Yes - Specialty:

Years:

Rank.and Corps:

Brief Summary of Civilian Experience:

Marital Status:

Married

Single/Divorced/Widow

Number of Family members (excluding active duty members):

To be completed by NAVMEDCOM/NAVCRUITCOM personnel

Grade:

 

 

 

 

Designator:

 

 

OIS Class:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Subspecialty Code(s):

1st

 

 

 

 

2nd

 

3rd

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Scholarship Student?

 

Yes

 

 

No

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

New Accession Bonus?

 

Yes

 

 

No

End of Obligated Service Date:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

NAVCRUIT 1131/16 (Rev 11-2011)

FOR OFFICIAL USE ONLY - PRIVACY SENSITIVE

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