SAMPLE PACKET
MDW Sergeant Audie Murphy Board
Enclosures:
1. CSM Nomination Worksheet
2. 1SG Performance Test
3. Recommendation Letter
4. Biographical Fact Sheet
5. DA 705 and DA Form 5500/01
6. DA 5790-R- Weapons Qualification
(Body Fat content when applicable)
7. Enlisted Records Brief
(With color photo)
8. DD 2266 Home Town News Release
Department of the Army
appropriate letterhead
Date
MEMORANDUM FOR SAMC Selection Board
SUBJECT: Sergeant Audie Murphy Club Nomination and Worksheet
NAME: ______SSN: ______
RANK: ___ PMOS: ___ SMOS: DATE: ______
UNIT: ______
DUTY PHONE: ______MONTHS AT PRESENT JOB:
DUTY POSITION AND DATE ASSIGNED: ______
______
TIME IN SERVICE: _____ ETS: ______
CIVILIAN EDUCATION: _____ MILITARY EDUCATION:______
SECURITY CLEARANCE: ______
NO. PERSONS SUPERVISED:
CSM Name
CSM, USA
Command Sergeant Major
Department of the Army
appropriate letterhead
Date
MEMORANDUM FOR SAMC Selection Board
SUBJECT: SAMC Performance Test
1. The following performance test results are submitted for review.
NAME: ______SSN: ______
UNIT: ______DOR: ______DOB: ______
ETS: _____ PMOS: ___ NCOES: ______
NUMBER OF SOLDIERS SUPV:
AWARDS AND DECORATIONS: ______
PERSONAL PERFORMANCE ACHIEVEMENTS:______
APFT: ______WEAPON QUAL: ______
Candidate has never received an Art. 15 as aN NCo._____(Initial)
SUBORDINATE PERFORMANCE
ACHIEVEMENTS:______
Section APFT Average: ______
2. The following information concerning discipline of subordinates is provided:
AWOL #: UCMJ #:
DUI #:
(Candidate Print & Sign) 1SG Signature Block
______1SG, USA
Department of the Army
appropriate letterhead
Department of the Army
appropriate letterhead
Date
MEMORANDUM FOR RECORD
SUBJECT: Sergeant Audie Murphy Club Recommendation for Staff Sergeant XXXXXX
1. It is with gratitude and great honor that I recommend SSG xxxx for induction into the prestigious Sergeant Audie Murphy Club. SSG xxxx is a highly skilled Non-Commissioned Officer who embodies the auspicious spirit of Sergeant Audie Murphy himself. SSG xxxx has consistently operated in positions of great responsibility and sought ways to improve the organization, while working for the betterment of the Soldiers in it.
2. SSG xxxx is an outstanding Leader that I can count on without hesitation to take the appropriate actions in the absences of orders. Once SSG xxxx is given a task, I can rest assured the task will be met with outstanding results. He is extremely dedicated to the mission and always places the units, his Soldiers and Army’s needs above his own. He is a valuable asset to the community, always willing to lend a helping hand.
3. SSG xxxx personifies the Army physical standards and always has a personal appearance worthy of emulation. SSG xxxx is an energetic and conscientious NCO who has proven himself as a top performer by being selected as the Group NCO of the Quarter for all four quarters as well as the Group NCO of the Year. He is also extremely dedicated to the professional development of Soldiers, and was directly responsible for shaping and grooming the Soldier who was selected as the Group Soldier of the Year, and also promoted from Specialist to Sergeant.
4. SSG xxxx embodies the four NCO Philosophies: loyalty, discipline, professionalism, and caring that the Sergeant Audie Murphy Club was built upon. I have no reservations that this outstanding NCO will serve as a Sergeant Audie Murphy Club as an ambassador and mentor for the rest of his military career and beyond.
5. The point of contact for this memorandum is the undersigned at 703-xxx-xxxx
EXAMPLE R. SMITH
CPT, MI
Commanding
BIOGRAPHICAL SKETCH (EXAMPLE)
NAME:
RANK:
DATE OF RANK:
DATE OF BIRTH/PLACE OF BIRTH:
DATE JOINED ARMY:
CIVILIAN EDUCATION:
MILITARY EDUCATION: (example format)
1997 Basic Combat Training, Fort Leonard Wood, MO
1997 Combat Medic Course, Fort Sam Houston, TX
2000 Warrior Leaders Course, 7th Army NCO Academy, GE
2001 Respiratory Therapist Course, Fort Sam Houston, TX
2002 Air Assault Course, Fort Polk, LA
2004 Battle Staff Non-Commissioned Officer Course, Fort McCoy, WI
2004 Advanced Leaders Course, Fort Sam Houston, TX
2005 Basic Airborne Course, Fort Benning, GA
2006 Senior Leaders Course, Fort Sam Houston, TX
ASSIGNMENTS: (example format)
1998
2001
2003
2003 Platoon Sergeant
2004 S-3 Schools NCO
2005 Shift Leader
2006 NCOIC,
FAMILY: Husband, John Doe, Daughter(2yrs) Jane Doe
.AWARDS AND DECORATIONS: (example format)
Meritorious Service Medal (1), Army Commendation Medal (2), Army Achievement Medal (4), Good Conduct Medal (3), Global War on Terrorism Service Medal, National Defense Service Medal, Overseas Ribbon, NCO development ribbon with numeral 3, Airborne badge, Air Assault badge
GOALS:
Long Term:
Short Term:
INSERT HERE DA 705
AND
DA 5500-R/ DA 5501-R
INSERT HERE DA FORM 5790-R
WEAPONS QUALIFICATION
INSERT A COPY OF THE ENLISTED RECORDS BRIEF WITH COLOR PHOTO
HOMETOWN NEWS RELEASE INFORMATION1. PAO CODE / PRINT OR TYPE - SEND ORIGINAL ONLY / FOR RELEASING PUBLIC AFFAIRS OFFICE USE ONLY
2. YOUR SOCIAL SECURITY NUMBER (For identification only)
PRIVACY ACT STATEMENT
AUTHORITY: 5 U.S.C. 301, 10 U.S.C. 8012 and 8034, and EO 9397.
PRINCIPAL PURPOSE: To prepare news stories and news releases for distribution and publication by civilian news media to recognize the achievements of Army
and Air Force members. In accordance with the 1974 Privacy Act, you are hereby informed that your Social Security Number on this form is required for
identification use only.
ROUTINE USE: Information may be disclosed to civilian news media representatives. Once published, information is considered "Public Domain."
DISCLOSURE : Information collected on this form is released over your signature and is voluntary. If you have no objection to the information being released to
hometown audiences, sign your name below. Failure to provide the information may mean little or no public news release material can be produced, thus
denying the individual public recognition for personal achievements.
3. BRANCH OF SERVICE / 4. STATUS / 5. RANK / 6. PAY GRADE / 7. FIRST NAME, MIDDLE INITIAL, LAST NAME / 8. SEX
ARMY
AIR FORCE NAVY
MARINE CORPS
COAST GUARD / ACTIVE RESERVE NATIONAL
GUARD
CIVILIAN
9. EVENT (Example: Arrival; Promoted to Sergeant; Received Commendation Medal, etc.- Citation Needed)
10. YOUR LIVING PARENTS, STEPPARENTS, GUARDIANS, AUNT/UNCLE/GRANDPARENTS OR ADULT SIBLINGS
a.(1) FIRST NAME, MIDDLE INITIAL, LAST NAME / (2) RELATIONSHIP TO YOU
(3) ADDRESS (Number and Street) / (4) CITY / (5) STATE / (6) ZIP CODE
b.(1) FIRST NAME, MIDDLE INITIAL, LAST NAME / (2) RELATIONSHIP TO YOU
(3) ADDRESS (Number and Street) / (4) CITY / (5) STATE / (6) ZIP CODE
11. SPOUSE'S NAME (First, Middle Initial, Last)
12. SPOUSE'S LIVING FATHER a. FIRST NAME, MIDDLE INITIAL, LAST NAME
b. ADDRESS (Number and Street) / c. CITY / d. STATE / e. ZIP CODE
13. SPOUSE'S LIVING MOTHER a. FIRST NAME, MIDDLE INITIAL, LAST NAME
b. ADDRESS (Number and Street) / c. CITY / d. STATE / e. ZIP CODE
14.a. YOUR PRESENT UNIT OF ASSIGNMENT
(Do not abbreviate) / b. POST OR BASE (Not APO) / c. CITY / d. STATE OR COUNTRY
15. DUTY MOS OR AFSC / 16. PRESENT JOB TITLE (Full Title - Do not abbreviate) / 17. TOTAL YEARS MILITARY SERVICE
18.a. HIGH SCHOOL GRADUATED FROM / b. YEAR GRADUATED / c. CITY / d. STATE / e. ZIP CODE
19. COLLEGES GRADUATED FROM
a. COMPLETE NAME / b. DEGREE / c. YEAR GRADUATED / d. CITY / e. STATE / f. ZIP CODE
20. REMARKS (Continue on back if necessary)
21. SIGNATURE OF PERSON LISTED ABOVE (Authorizing release of this information) / 22. DATE (YYMMDD) / 23. DUTY PHONE
(DSN or area code)
DD FORM 2266, JUN ‘95