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pdfOMB No. 0704-0167
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REQUEST FOR REFERENCE
The public reporting burden for this collection of information is estimated to average 10 minutes per response, including the time for reviewing instructions,
searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments
regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing the burden, to the Department of Defense,
Washington Headquarters Services, at whs.mc-alex.esd.mbx.dd-dod-informationcollections@mail.mil. Respondents should be aware that notwithstanding any
other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB
control number.
Please DO NOT return your form to the above address. Return completed form to the recruiting representative listed in Section I.
THIS FORM CONTAINS PERSONALLY IDENTIFIABLE INFORMATION PROTECTED BY THE PRIVACY ACT OF 1974
SECTION I - RECRUITING REPRESENTATIVE IDENTIFICATION
2. SIGNATURE OF RECRUITING REPRESENTATIVE
1. NAME (Last, First, Middle Initial, Rank)
UNIT/COMMAND NAME
MAILING ADDRESS (Street, City, State, and ZIP Code)
3. DATE SIGNED (YYYYMMDD)
4. E-MAIL
5. PHONE NUMBER
NEEDS DD67
INSTRUCTIONS
The below-named person has made application for enlistment in the
Armed Service and has given your name as a reference. The
information you provide will be appreciated since it will assist in
determining whether or not the applicant meets the eligibility
standards to become a member of the Armed Forces of the United
States.
Service standards require that applicants be mature, intelligent, and
possess high moral qualifications. Those applicants who are selected
will have an opportunity to receive schooling and training in technical
fields to improve and advance their knowledge and skills in subjects
essential to national defense. Additionally, college opportunities will be
available.
Enlistees who cannot adjust satisfactorily to military life must be
discharged, causing emotional distress to the individual, as well as
loss to the taxpayers. Therefore, by giving your frank opinion of the
applicant, you can render a genuine service to the applicant as well
as to the United States.
Your statements will be held in strict confidence, and you will not be
considered personally responsible in any way for the applicant's
conduct if enlisted or not enlisted.
Your answers to the questions listed on the back of this form are of
particular interest in reaching a conclusion concerning the
qualifications of the applicant. Any information you can provide will be
appreciated.
7. MAILING ADDRESS (Street, Apartment Number, City, State, and ZIP Code)
6. NAME (Last, First, Middle Initial)
8. DATES OF SCHOOL ATTENDANCE OR EMPLOYMENT
a. FROM (YYYYMMDD)
b. TO (YYYYMMDD)
SECTION III - REFERENCE (To be filled out by person referring applicant)
9. APPLICANT'S NAME (Last, First, Middle Initial)
10. WHAT IS YOUR RELATIONSHIP TO THE APPLICANT? (Indicate with an "X")
a. EMPLOYER
b. SCHOOL OFFICIAL
11. HOW LONG HAVE YOU KNOWN THE APPLICANT?
a. FROM (YYYYMMDD)
c. OTHER (Specify)
12. APPLICANT'S HIGHEST SCHOOL GRADE COMPLETED OR JOB TITLE
b. TO (YYYYMMDD)
DD FORM 370, 20200518 DRAFT
PREVIOUS EDITION IS OBSOLETE.
Page # of ##
13. INCLUSIVE DATES OF SCHOOL ATTENDANCE/EMPLOYMENT IN
YOUR SCHOOL OR FIRM
a. FROM (YYYYMMDD)
14. IF APPLICANT LEFT SCHOOL OR JOB, OR WAS EXPELLED,
DISMISSED, OR TERMINATED, GIVE SPECIFIC REASON IF KNOWN
b. TO (YYYYMMDD)
(Indicate with and "X")
15. HOW DO YOU RATE THE APPLICANT'S:
OUTSTANDING
AVERAGE
UNSATISFACTORY
NOT OBSERVED
a. TRUSTWORTHINESS
b. ADAPTABILITY
c. ABILITY TO WORK WELL WITH OTHERS
d. INITIATIVE
e. JUDGMENT
f. PHYSICAL FITNESS
g. LEADERSHIP
h. MATURITY
i. DEPENDABILITY
PLEASE ANSWER THE FOLLOWING QUESTIONS TO THE BEST OF YOUR KNOWLEDGE.
FOR "YES" ANSWERS, PROVIDE DETAILS IN REMARKS.
(Indicate with an "X")
YES
NO
NEEDS DD67
UNKNOWN
16. IF APPLICANT IS KNOWN TO USE ALCOHOL OR DRUGS, HAS IT AFFECTED HIS OR HER
PERFORMANCE? (If Yes, explain below)
17. IS THERE ANY REASON WHY YOU WOULD NOT RECOMMEND THIS PERSON FOR THE
ARMED FORCES? (If Yes, explain below)
18. PLEASE WRITE A PERSONAL NARRATIVE EVALUATION OF THE APPLICANT BELOW, OR ON A PLAIN PIECE OF PAPER, AND ATTACH TO THIS
FORM. SPECIFICALLY ADDRESS THE ABOVE ITEMS. IF ITEM 15 IS MARKED "YES," PLEASE EXPLAIN IN DETAIL.
19. PERSON COMPLETING SECTION III
a. TYPED OR PRINTED NAME (Last, First, Middle Initial)
c. PHONE NUMBER
DD FORM 370, 20200518 DRAFT
b. TITLE\SCHOOL\COMPANY
d. SIGNATURE
PREVIOUS EDITION IS OBSOLETE.
e. DATE SIGNED (YYYYMMDD)
Page # of ##
File Type | application/pdf |
File Title | DD Form 370, Request for Reference |
Author | WHS/ESD/IMD |
File Modified | 2020-05-19 |
File Created | 2020-05-19 |