SECNAVINST 1412.9B - Headquarters Marine Corps

SECNAVINST 1412.9B7 Feb 2006DATA SHEETInstructions: Applicant must complete items A through K (or L, ifapplicable) utilizing the space provided in column 2. Please use Courier orPica 10 pitch print. ALL CHARACTERS MUST BE IN CAPS.COLUMN 1 COLUMN 2A. LAST NAMEB. FIRST NAMEC. MIDDLE INITIALD. SSN (NO SPACES)E. PRESENT GRADEF. PRESENT MOSG. MOS FOR WHICH APPLYING (1 ST CHOICE ONLY)H. RACE/ETHNIC CODE (PER BTR)I. AGE (AS OF COMMISSIONING DATE – YY MM)J. ACTIVE NAVAL SERVICE (AS OF COMM DATE – YY MM)K. EL/GT SCORE (AS APPROPRIATE)L. RESERVE ON FTS (IF APPLICABLE) Y / N (CIRCLE ONE)----------------HQMC----------ACTION-------------ONLY-----------CHECKLISTENDORSEMENTS______ PHOTOGRAPH _______ RECOMMENDED/NOTRECOMMENDED______ PAGE 12, SRB______ PAGE 8A, SRB MISSING______ PAGE 3, SRB _______ EL VERIFICATION______ ROS (Sgts only) _______ BIR & BTRBIR & BTR _______ PAGE 12______ CITIZEN _______ PAGE 8A______ DOB _______ PAGE 3/ROS______ R/E _______ NAC EVIDENCE______ ANS/TIS______ EL/SAT______ NAC*TO BE REPRODUCED AS NEEDED*3Enclosure (6)