Fort Bragg NCOA BLC PEC with Data Sheet and ... - United …

NCOA STUDENT PERSONAL DATA

XVIII AIRBORNE CORPS AND FORT BRAGG NCO ACADEMY

FORT BRAGG, North Carolina 28310-5000

LAST NAME

Gender

Rank

FIRST NAME

Date of Rank

Home / Cell Phone#:

College Experience:

GT Score:

Field of Study:

M.I. / JR/II

Current promotion Point Cut-off

Current # of promotion points

5 Digit MOS:

SSN

Profile:

Type:

College/University Attended:

CURRENT UNIT ASSIGNED:

CO/BTRY/TRP:

BN/SQD:

BCT/BDE/GRP:

DIVISION and MAJOR COMMAND:

CONTACT INFORMATION: (need rank, name, phone #, and email for everyone)

SPONSOR:

PLATOON SERGEANT:

FIRST SERGEANT:

BRIGADE CSM:

BN STAFF DUTY PHN #:

DATA REQUIRED BY THE PRIVACY ACT OF 1974

Title of Form: Student Personal Data Sheet

Prescribing Directive: 10 USC 3012 Authority: 10 USC 3012

Routine Uses: Any information you provide is disclosable to members of the Department of Defense who have a need for the

information in the performance of their duties. In addition the information may be disclosed to Government agencies outside

the Department of Defense. Mandatory or Voluntary Disclosure and Effect of Individual not providing information: Providing

the information is voluntary. Individuals not providing the requested informaiton will not be admitted into the course.

I fully understand that providing false information on this form is a violation of the NCOA Honor Code and may result in my

dismissal from the NCO Academy. Futhermore, I understand that if I am dismissed for providing false information I could be

subject to the provisions of the UCMJ by my unit.

Student digital signature

21 APR 16 (All previous Versions are Obsolete)

UNIT PRE-EXECUTION CHECKLIST

(For use of this form, see TRADOC Regulation 350-18; Proponent is TRADOC G-3/5/7, TOMA)

Fillable form; may be printed and signed manually.

1. NAME:

2. UNIT:

3. COURSE TITLE:

Supervisor's

Initials

4. REPORT DATE:

Soldier's

Initials

PART I- UNIT PRE-EXECUTION (Day-90 to Day-1)

Coordination between unit and school to identify the Soldier by name and reservation status?

Soldier in receipt of read ahead packet, school/course information, and graduation requirements?

Soldier completed prerequisite course/testing? (DA Form 1059 or other completion document)

All required clothing/equipment in accordance with school/course information packet?

Soldier meets physical readiness standards of AR 350-1? (APFT within 60 days)

Soldier meets height/weight and body composition standards of AR 600-9?

Soldier has Government Travel Card or adequate cash/traveler checks?

Individual orders received (10 copies)?

Soldier has current periodic health assessment (PHA) and dental exam?

Soldier meets physical qualifications for special skills as specified in AR 40-501?

Soldier meets remaining Time in Service (TIS) requirement?

Transportation verified/DTS approved?

Soldier has current/valid identification card?

Soldier has ID tags (1 pair)?

Unit POC List:

Phone Number with Area Code

CDR Office:

Other:

1SG Office:

Other:

FTM Office:

Other:

Unit Fax:

1SG Email:

CSM Email:

TRADOC Form 350-18-2-R-E, APR 2018

Previous editions are obsolete

Page 1 of 2

PART II - ROUTINE PREREQUISITES

TASK

Minimum Aptitude Score

SOLDIER DATA

REGULATION DATA

CL

CO

EL

FA

GM

CL

CO

EL

FA

GM

GT

MM

OF

SC

ST

GT

MM

OF

SC

ST

(if applicable)

Key: CL-Clerical/ADMIN; CO-Combat/CMBT; EL-Electronic/ELEC; FA-Field Artillery/FA; GM-General Maintenance/MAINT; GT-General

Technical/GT; MM-Mechanical Maintenance/MECH; OF-Operators & Food/FOOD; SC-Surveillance & Communication/COMM; ST-Skilled

Technical/TECH

Physical demand rating/profile

(PULHES)

P

U

L

H

E

S

P

U

L

H

E

S

*See Part Ill for PT profiles

Key: P- Physical capacity/stamina; U- Upper extremities; L- Lower extremities; H- Hearing/ear; E- Eyes; S- Psychiatric

Military and civilian vehicle operator license(s) (if applicable):

Military license number:

Expiration date:

Civilian license number:

Expiration date:

State:

PART Ill - REQUIRED DOCUMENTS

Security clearance (if applicable, attach as required)

*Permanent profile attendees must have a signed copy of completed DA Form 3349; must include Army doctorapproved alternate aerobic event for APFT. Provide results of medical retention board (if applicable).

All required waivers (if applicable)

Other requirements (if applicable)

Other requirements of DA PAM 611-21 not previously listed:

Other requirements (if applicable)

Other requirements (if applicable)

Other requirements (if applicable)

Other requirements (if applicable)

I have been counseled and have read all requirements applicable to the course I'm selected to attend. Attendance at this course

and class will not pose any known hardship on me and/or my family that would detract from or prevent my successful

completion of course requirements.

Student's Signature:

I have reviewed the above Soldier's qualifications and potential to successfully complete this course, counseled them on these

requirements, and hereby verify their readiness to attend.

Commanding Officer (typed name):

Commanding Officer's Signature:

TRADOC Form 350-18-2-R-E, APR 2018

Previous editions are obsolete

Page 2 of 2

XVIII Airborne Corps and Fort Bragg NCO Academy

Basic Leader Course (BLC) Packing List

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

29

30

31

32

33

34

35

36

37

38

39

40

41

42

43

44

45

46

47

48

49

50

51

52

53

MANDATORY, NON-SEASONAL ITEMS

OCP Uniform complete (see notation 3)

Set, Velcro nametag w/US Army (unless sewn on)

Set, Velcro US Flag

Set, Velcro Rank (unless sewn on)

Set, Velcro Unit patch

Cap, Patrol w/nametag and rank

Belt, Rigger, Tan/Coyote

Boots Combat, Tan/Coyote

Socks, Boot (Solid OD or Foliage Green, Brown or Black)

Undershirt (Sand/Tan 499)

Undergarments (if applicable)

Brassieres (if applicable)

Leather Work Gloves Initial Issued (Foliage Green or Black)

Light Weight Wool Glove Liner (Foliage Green, Black, Brown)

APFU Jacket

APFU Trousers

APFU T Shirt Long Sleeved

APFU T Shirt Short Sleeved

APFU Trunks w/liner

Socks, Athletic Calf or Crew Length (white or black)

Running Shoes

Black Cap, Synthetic Micro Fleece

Towel Brown or Neutral Color

Wash Cloth Brown or Neutral Color

Wet/Cold Weather Jacket and Trousers

ASU (jacket/trousers, for male/female)

ASU Shirt/LS

ASU Shirt/SS

All Weather Coat with Rank for male/female

Black Four Hand Tie (male)

Beret, Organizational (w/DUI)

Black Neck Tab (female)

Belt Web w/Brass Tip

Buckle Solid Brass

Shoes, Black Oxford Low Quarters or Jump Boots (unit dependent)

Undershirt, White (male)

Socks, Dress Black

Name Plate

All authorized awards & accoutrements (IAW with SRB)

Civilian attire, casual wear (if TDY)

Dress Gloves, Unisex Military Issue

Duffle Bag

Barracks Bag

Head Lamp or L Shaped Flashlight (red/clear lens w/2 sets of

Identification Card (CAC)

Identification Tags with SM/LG Chain

Personal Hygiene/Shaving Kit Complete

Army Approved Eye Protection

FLC set up complete w/ all issued pouches

Tactical Back Pack or Assault Pack (foliage green, solid

black, OCP pattern, coyote brown)

PT Belt

Military Issued Water Source (Camelback)

MREs

4SET

2EA

2EA

2EA

2EA

1EA

1EA

2PR

7EA

7EA

7EA

7EA

1EA

2EA

1EA

1EA

2EA

2EA

2EA

7EA

1PR

1EA

2EA

2EA

1PR

1EA

1EA

1EA

1EA

1EA

1EA

1EA

1EA

1EA

1PR

2EA

2PR

2EA

1EA

2PR

1PR

1EA

1EA

1EA

1EA

1PR

1EA

1SET

1SET

SEASONAL/COLD WEATHER CLOTHING (1 OCT - 1 APR)

Level I Light Weight Shirt & Drawers (Silk Top/Bottoms)

2PR

Level II Mid Weight Shirt & Drawers (Waffle Top/Bottoms)

1PR

CLASSSROOM ITEMS NEEDED

1 Blank Rewritable CD Media

4EA

2 Composition Note books College or Wide ruled

3EA

3 Protractor, GTA 05-02-012

1EA

4 Pencil, Mechanical .5mm

2EA

5 Pens, Black

2EA

6 Zip Lock Bags M/L

1BX

7 Eye Glasses (if applicable)

2SET

8 Wrist Watch

1EA

9 Military Compass, Lensatic

1EA

10 3X5 Note Cards

1PK

SUGGESTED OR OPTIONAL ITEMS

1 Hangers Plastic or Wire

10EA

2 Highlighter Markers (HI-LITER)

2EA

3 Insect Repellent

1EA

4 Sun Screen

1EA

5 Sewing Kit Complete

1EA

6 Dress Uniform Measurement Tool & Guide Book

1EA

7 Leaders Book Complete

1EA

8 Locks with two keys, or Combination Locks

3EA

9 Laundry Detergent Liquid, Powder or Pods

1PK

10 1-1/2 Inch Binder with Document Protectors

1SET

11 Pocket Note Pad

1EA

1

2

1EA

1EA

1EA

2EA

NOTES:

1. Army Service Uniform (ASU) must include 2 x name plates, branch insignia, all authorized ribbons and decorations, 2 x Unit Crests, special Skill

Badges/Combat Badges (if authorized). All items for Infantry personnel are authorized as well as Foreign Badges and Unit Awards. Marksmanship

and Driver Badges are also authorized. Soldiers will arrive to BLC with their Dress Uniform properly fitted, clean, pressed and presentable, with all

awards, decorations, badges, and name plates affixed.

2. Students will bring the Oxford Low Quarter Dress Shoes for inspection purposes. Unit Authorization footwear will be worn for graduation if

conducted in ASU

3. All students are required to have two complete sets of accoutrements for their OCP uniform; including Velcro unit patches, rank, nametapes and

U.S. Army tapes, along with subdued skill and occupation badges (if applicable). The U.S. embroidered-colored insignia flag is the only authorized

insignia. The U.S. Army & nametapes, rank, and special skill badges MAY be sewn on uniforms as an alternative to Velcro insignias.

4. All uniforms and uniform components brought for wear and layout purposes must be clean and serviceable. At no time will soldiers bring

uniforms or uniform components that are faded or have holes, rips, tears, stains, dirty and/or missing pieces of the component.

5. Cold weather equipment will vary by installation, regional conditions, and availability of ECWCS equipment. Not all installations are

issued the same cold weather gear; seasonal temperattures, the installation andd NCOA policies regulate the appropriate equipment needed

in cold climates during the course.

I acknowledge that the items listed in this packing list have been laid out and inspected prior to arrival at

the BLC. Furthermore, I understand that if any deficiencies are annotated during the initial layout of this

equipment, I will have no more than 72 hours from the time of the initial layout to fix the deficiency, or be

recommended to the Commandant for dismissal from the BLC IAW the approved Course Management

Plan (CMP) dated January 2019. Lastly, I confirm that I have a CAC card with a working pin and am able

to access my military email account.

____________________________________________

Student Signature

____________________________________________

First Line Supervisor

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