APPLICATION FOR ACTIVE DUTY
For use of this form, see AR 135-210; the proponent agency is DCS, G-1.
DATA REQUIRED BY THE PRIVACY ACT OF 1974
Title 10 USC, 672(d), 10 USC 275.
Used by Reserve Component soldiers to apply for active duty programs announced by HQDA. Application
is reviewed to determine the member's eligibility for announced active duty requirements.
To determine qualifications and make final selection of individuals applying for active duty. Also used to
schedule medical examinations, security screening and to issue active duty orders.
Disclosure of personal information is mandatory for soldiers applying for active duty programs announced by
SEE INSTRUCTIONS ON PAGE 2 BEFORE COMPLETING THIS FORM.
2. TO: Commander,
4a. PRESENT RESERVE GRADE
4b. RESERVE COMPONENT
3. FROM (Last, First, MI)
6a. PERMANENT HOME ADDRESS (Include ZIP code)
6b. PHONE NO. (Include area
7a. TEMPORARY ADDRESS (Include ZIP code)
7c. PHONE NO. (Include area
ITEM 8 TO BE COMPLETED ONLY BY PERSONNEL CURRENTLY SERVING ON ACTIVE DUTY IN A WARRANT OFFICER OR
8a. PRESENT ACTIVE DUTY GRADE
8b. ORGANIZATION AND STATION ASSIGNMENT
9. I hereby volunteer to enter on active duty, for the period indicated below, in my branch or any of the following branches that I
may be qualified for; and if accepted for active duty in another branch, I request transfer to that branch: (Check as appropriate)
a. FOR A PERIOD OF
b. FOR AN INDEFINITE PERIOD
c. OTHER BRANCHES (List in order of preference)
10. I understand that if accepted for active duty I may be assigned to any command, including an overseas command, to fill any
Army-wide vacancy. However, I would like to be considered for one of the three duty assignments and areas of assignment listed
below in the order of my choice.
CHOICE NO. 1
CHOICE NO. 2
CHOICE NO. 3
a. DUTY ASSIGNMENT
b. AREA ASSIGNMENT
11. If it is possible, I prefer to enter on active duty during one of the three periods indicated below in order of preference:
PREFERENCE NO. 1 (Month and Year)
PREFERENCE NO. 2 (Month and Year)
PREFERENCE NO. 3 (Month and Year)
12. Upon receipt of active duty orders, I will require the time indicated below to settle my affairs for entry on active duty. (Check
AVAILABLE ON DATE OF RECEIPT OF ORDERS
13. REMARKS (If more space is needed, continue on separate sheet)
14. SIGNATURE OF APPLICANT
PREVIOUS EDITIONS ARE OBSOLETE.
APD PE v1.00ES
DA FORM 160-R, JUL 2010