Ngb Form 594 1 – Fill Out and Use This PDF

ANNEX		DD FORM 4/DA FORM 4836

ARMY NATIONAL GUARD SIMULTANEOUS MEMBERSHIP PROGRAM AGREEMENT

The proponent agency is ARNG-HRH. The prescribing directive is the Army National Guard Accession Options Criteria.

PRIVACY ACT STATEMENT

AUTHORITY: Title 10 USC Section 12101 and 12103, Title 32 USC Section 301 and 304.

PRINCIPLE PURPOSE: This is an annex to the DD Form 4, allowing the enlistee to pursue a commission as an officer through the Reserve Officer Training Corp (ROTC). The original will be maintained in the Soldiers Official Military Personnel File or electronically filed in a DoD approved system. A copy will be maintained by the MILPO for state records. For organizational use only.

ROUTINE USES: None.

DISCLOSURE: Voluntary; However, applicable portions must be completed if the applicant desires to be enlisted in the Army National Guard under the Simultaneous Membership Agreement.

Section I - Administrative Data

Applicant's Name (Last , First, M.I.)

Section II - Agreements

1. I hereby agree to this amendment of my previous Agreement as follows and understand that:

b.I am required to apply for enrollment in the Advanced ROTC Course, if not already enrolled, within 1 year from the date of this Amendment.

c.Should I be a member of the USAR Control Group (ROTC), I will be discharged from the USAR Control Group (ROTC) and transferred for enlistment / reenlistment in the ARNG.

d.Should I later be awarded an Army ROTC scholarship, which does not provide for Reserve Forces Duty (RFD), or is not a 2 year Junior Military College Scholarship, I will be discharged from the ARNG and transferred for assignment to the USAR Control Group (ROTC) prior to acceptance of such scholarship.

e.I may not, when a commissioned officer, apply credits which stem from enlisted service performed concurrently with Advanced ROTC Course training toward computation of length of service for any purpose.

f.I will volunteer for comissioning under the ROTC Early Commissioning Program if upon completion of the ROTC Advanced Course I am not scheduled to receive, within 8 months, a baccalaureate degree.

g.Upon becoming a SMP participant, I must have 4 years remaining on my original or extended enlistment / reenlistment contract in the Selected Reserve from date of enrollment in the SMP.

h.Unless I obtain a Guaranteed Reserve Forces Duty (GRFD) contract prior to enrollment in Advanced ROTC, I will serve with the ARNG after commissioning until I obtain a baccalaureate degree. Upon obtaining the degree, I will then be selected for either Reserve Forces Duty or Extended Active Duty according to the needs of the service. GRFD cadets with a dedicated ARNG scholarship, must serve their commitment in the ARNG.

2.Additional details of my participation in the SMP are outlined in the remarks section.

APPLICANT'S INITIALS _____________

Section III - For All Direct SMP Enlistments / Reenlistments

3.My enlistment / reenlistment in the ARNG is for the purpose of directly participating in the Simultaneous Membership Program. As a participant in the SMP, I understand that:

a.If I fail to apply for enrollment in the Advanced ROTC Course, as required I will:

(1)Be deleted from the SMP

(2)Be retained in the enlisted grade held prior to participation in the SMP

(3)Be required to execute the terms of my enlistment / reenlistment agreement excluding this amendment, and

(4)Complete Basic Training (BT) and Advanced Individual Training (AIT) if not previously completed.

b.If I apply for enrollment in the Advanced ROTC Course, but fail to be accepted, then I may:

(1)Elect deletion from the SMP in order to continue in an enlisted status as if I had failed to apply for enrollment (para. 3a,above), or

(2)Elect discharge as a Reserve of the Army and as a member of the ARNG.

c.If I am enrolled in the Advanced ROTC Course and fail to volunteer for ECP, and as required, fail to accept a commission or fail to be tendered a commission, then I will be deleted from the SMP and be required to continue in an enlisted status as if I had failed to apply for enrollment (para. 3a, above).

APPLICANT'S INITIALS _____________

Section IV - For Current ARNG Members Electing Participation In SMP

4.As a current ARNG member, my original enlistment / reenlistment agreement is to be held in abeyance in order that I may participate in the SMP. As a participant in the SMP, I understand that -

a.Upon acceptance into SMP, I am not eligible to continue in the ARNG Incentive Program. (Refer to applicable Incentive agreements for Termination and Recoupment terms)

b.If I am disenrolled from or I fail to complete the Advanced ROTC Course, or fail to be tendered a commission or accept a commission, or fail to volunteer for the ROTC Early Commissioning Program, then provisions of para. 3a, above, apply.

APPLICANT'S INITIALS _____________

Section V - Confirmation of SMP Agreement

5. My acceptance into the SMP is based on my desire to volunteer for the program which requires enlisted status for eligibility.

I certify that I have carefully read and understand this document. Any questions I had were explained to my satisfaction. I fully understand that only those

agreements in section A andof this document, or those recorded and acknowledged by me, will be honored. Any other promise,

representation, or commitment made to me for the Simultaneous Membership Program is written in my handwriting, or here waived. (If none, write "NONE").

(Include brief description of any recorded document other than this agreement.)

APPLICANT'S INITIALS _____________

This document is null and void until ALL signatures are completed and returned to HQ, Cadet Command

ROTC Program

Typed Name and Grade of Professor of Military Science			PMS's Signature		Date
Name of School					Applicant MS Year
Scholarship Type:
Dedicated Guard	Conversion Dedicated Guard	Non-scholarship	Conversion GRFD	Guaranteed Reserve Forces Duty (GRFD)

Unit Commander's Acceptance

Unit Name and Address (for which enlisted)

State OSM Authentication

State		Recruiting Commander Name and Grade
GRFD Control Number Required:		GFRD Control Number
Yes	No

Remarks

Applicant

NGB FORM 594-1, 20140302

(PREVIOUS EDITIONS ARE OBSOLETE)

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