NYANRG REG 611-2, 1 Dec 2001

   Today's Date (The date you prepared or signed this document)

NAME:  FIRST - MIDDLE - LAST       ADDRESS:  Street Address
RANK:  Sergeant First Class                  City, State, Zip
SSN:   999-99-9999                           (Telephone Number)

                                      UNIT:  257th PSC, NYARNG
                                             122 Armory Road
                                             City, State, Zip
                                             (Telephone Number)

OBJECT: To obtain an appointment as a NYARNG warrant officer,
in MOS 420 AO, Miltary Personnel Technician, or to obtain
certification for redesignation into MOS 420A, Military
Personnel Technician.

PERSONAL DATA:

Date of Birth:  7 Sep 58          Marital Status:  Married
Height:         5' 9"            Dependents:  Three
Weight:         165 pounds                   MOS:  P75Z40/S71L40


CIVILIAN EDUCATION:

Bachelor of Science, University of Maryland, College Park, MD 
Associate of Arts, Central Texas College, Killeen, TX
Diploma, Orchard View High School, Muskegon, MI

MILITARY EDUCATION:

BNCOC                             Scope of training focused upon
US Army soldier Support Center    Leadership and MOS training at
Fort Benjamin Harrison, IN.       the middle management level.

PLDC                              Scope of training concentrated
III Corps NCO Academy             on leadership skills.
Fort Hood, TX.

Personnel Management Specialist   Initial MOS training that taught
Army Soldier Support Center       the basic skills in MOS 75H10

(If continued on additional page(s), include name & SSN in the following format at the top left of each page after the first.)

NAME:  FIRST - MIDDLE - LAST
SSN:   999-99-9999

(Whether you use additional page(s) OR not, the following headings and data are required, as are signature and date.)

MILITARY EXPERIENCE PERTINENT TO MOS 420AO:

Jul 90 - Present                Responsible for initiation and
Personnel Records Supervisor    maintenance of officer and enlisted
259th PSC, NYARNG               personnel and health records.
                                Supervise a team of 3 personnel
                                records specialists.

Jun 88 - Jun 92                 Responsible for initiation and
Personnel Records Specialist    maintenance of officer and enlisted
                                personnel and health records.

CIVILIAN EXPERIENCE PERTINENT TO MOS 420AO:

Jan 88 - Present                Review and process records of
Military Personnel Specialist   accessed enlisted soldiers to
MILPO, NYARNG                   assure documents are complete and
                                contain all required signatures.
                                Verify soldier met all eligibility
                                requirements.

SUMMARY:

Write a paragraph or two on why you feel you are fully
qualified to perform the duties of a warrant officer
in your skill area.

			Signature and Date