The Supplement to DA Form 1058 serves a critical yet often overlooked role in the administrative workflows of the U.S. Army, particularly within the chaplain corps. This comprehensive form, revised as of August 2012, is a testament to the meticulous planning and documentation essential for officers, especially those enrolled in or aspiring to join the chaplaincy. It captures a wealth of vital information, starting from basic identifiers like name and Social Security number, to specific details pertaining to one's military career—rank, date of commission, and date of rank. Additional layers of detail encompass educational credentials, such as completed seminary credits, shedding light on the preparatory journey these individuals have undertaken. The form presents a clear choice among components—AGR, TPU, IMA, IRR—thereby aligning one's service with the structural and operational dynamics of the army. Notably, it incorporates considerations for physical fitness through the inclusion of a recent diagnostic APFT Card, alongside logistical aspects related to assignments and travel preferences for training courses, including the mode of travel, with a pronounced preference for air travel to ensure the safety and well-being of soldiers over long distances. Furthermore, it navigates through the particularities of chaplain candidates, delineating pathways for basic officer leadership courses, including CH-BOLC and various practicums, all while emphasizing adherence to Joint Travel Regulations. The form also prompts for essential contact information, ensuring connectivity through both military and civilian email addresses. Lastly, it outlines the phases of the Chaplain Basic Officer Leader Course (CH-BOLC) completed to date, making it a pivotal tool in the orchestration of one's career trajectory within the chaplaincy of the U.S. Army.
| Question | Answer |
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| Form Name | Supplement To Da Form 1058 |
| Form Length | 1 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 15 sec |
| Other names | supp1058 supplement to da form 1058 fillable |
SUPPLEMENT TO DA FORM 1058
(Revised as of AUG 2012)
NAME: |
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SSN: |
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Rank: |
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Date of Commission |
Date of Rank: __________ Completed Seminary Credits (CCs):_______ |
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Component (check one): AGR__ TPU__ IMA__ IRR__ |
Have you attached a recent diagnostic APFT Card w/Ht.Wt.? ___ Yes |
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Do you have a Govt. Credit Card (check one): Yes ___ No ___ |
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COURSE |
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Name and Number |
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Start Date |
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End Date |
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Mode of Travel |
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1st Choice |
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AIR: __ |
POV: __ |
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(Privately Owned) |
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Vehicle) |
2nd Choice |
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AIR: __ |
POV: __ |
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3rd Choice |
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AIR: __ |
POV: __ |
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(Privately Owned) |
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INSTRUCTIONS |
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CHAPLAINS: |
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-Complete the above fields. Ensure you provide course number and dates in the above table.
-Provide your Date of Rank and Commission Date.
-If you select to travel by POV, we reserve the right in accordance with the Joint Travel Regulations to modify your travel to AIR. We will not authorize travel by POV over 450 miles for the safety and care of our Soldiers.
CHAPLAIN CANDIDATES:
-Complete the above fields to attend
-Prior to completing a practicum, you are required to complete CIMT and Phase 1 of
-Candidates requesting a practicum should chose a practicum at an installation near their home of record. Additional practicum’s are not limited to, but include EMM/CMM, National Defense University and the ROTC Summer training programs.
-Candidates are not authorized to complete Air Assault school or Airborne school as a practicum. Candidates are not authorized practicum’s in Germany, Hawaii or Alaska.
-If you select to travel by POV, we reserve the right in accordance with the Joint Travel Regulations to modify your travel to AIR. We will not authorize travel by POV over 450 miles for the safety and care of our Soldiers.
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ADDITIONAL NEEDED INFORMATION
AKO EMAIL ADDRESS: ____________________@us.army.mil
CIVILIAN EMAIL ADDRESS: ________________________________________
PLACE A CHECK MARK TO THE RIGHT OF THE PHASES OF
(This is for Newly Accessioned Chaplains and Chaplain Candidates Only)
CHAPLAINS: CIMT________ Phase 1________ Phase 2_________ Phase 3_________
CHAPLAIN CANDIDATES: CIMT________ Phase 1________ Practicum________ Phase 2_________ Phase 3_________
OFFICE USE |
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Date Received: |
ATRRS Registration: |
AORS RFO: |
Order Sent to SM: |
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