APPLE MD

APPLE MD a friend or yourself for HSC 109th Med to find out more about the Iowa National Guard. Send the following information to the unit or the recruiter. 

Name of Prospect:  ___________________________________

Address:  ____________________________________________

City:  _________________________ Zip Code: ___________

Phone Number:  _______________________________________

A - Age/Citizenship:  ________________________________

P - Physical Conditions:  ____________________________

          Height _________   Weight ___________

P - Prior Service:  __________________________________

*L - Law Violations    Yes______________    No____    

E - Education (Highest Grade Completed):  ____________

M - Marital Status:  _________________________________

D - Dependency (Number of Dependents):  ______________



Name of Member Submitting Lead: ______________________

Unit:  _______________________________________________

Comments:  ___________________________________________
*At this point in time it is not mandatory that the National Guard be advised of any law violations, but the information will be required before further processing can be accomplished.
Please return this form to your unit or the recruiter, SFC Geertz and SFC Bratton.
Phone: 319-337-3455
Email: geertzc@ia-arng.ngb.army.mil and brattond@ia-arng.ngb.army.mil
Snail-mail: HSC 109th Med
925 Dubuque St.
Iowa City, IA 52240.