SPONSORSHIP PROGRAM COUNSELING AND INFORMATION SHEET
For use of this form, see AR 600-8-8; the proponent agency is ACSIM.
DATA REQUIRED BY THE PRIVACY ACT OF 1974
AUTHORITY:
Title 5, USC Section 301.
PRINCIPAL PURPOSE:
Personnel service support. To counsel Soldier or civilian employee about sponsorship program entitlements, and provide information to gaining
battalion or activity of new members.
ROUTINE USES:
None. The DoD Blanket Routine Uses set forth at the beginning of the DoD's compilation of systems of records notices may apply to this system.
DISCLOSURE:
Mandatory for service members. Nondisclosure may prevent participation in the sponsorship program.
https://
1.
NOTE:
Soldiers/Famify members/Civilians may retrieve information regarding their new assignment at
Army Knowledge Online -
I have been counseled on the
I would like to have a sponsor assigned to me.
(Complete remainder of form.)
FOR CIVILIAN EMPLOYEES ONLY:
Total Army Sponsorship Program
I decline the offer of sponsorship.
(Complete Section 1 only.)
Typed or Printed Name:
Rank/Grade:
MOS/Branch/Civilian Occupational Series:
Signature:
Date:
2.
ARRIVAL INFORMATION TO ASSIST GAINING UNIT OR ACTIVITY:
If additional space is necessary, please attach your documentation to the form)
a.
I
(Rank/Grade and Name):
, am on assignment to
(Gaining Installation):
and expect to arrive on/about
(Month and Year):
b.
Soldier's/Civilian's contact information:
Current Unit/Activity Address:
DSN Phone number:
Cell Phone number:
Email address:
Other
(i.e., Social Media):
Leave Address and Phone number at this address until:
Status
(check one):
Married-accompanied
Single-accompanied
Married-unaccompanied
Single-unaccompanied
c.
Exceptional Family
d.
Accompanied by Family members:
NAME
AGE
SEX
RELATIONSHIP
Member Program (EFMP)
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
3.
GAINING UNIT/ACTIVITY INFORMATION:
If additional space is necessary, please attach your documentation to the form)
a.
d.
Gaining Unit/Activity:
Unit 1SG/Supervisor:
b.
Unit CDR/Supervisor:
Phone number:
Phone number:
Email address:
Email address:
e.
TASP Unit Coordinator:
c.
Unit sponsor:
Phone number:
Phone number:
Email address:
f.
Email address:
Date of initial contact:
If additional space is necessary, please attach your documentation to the form)
4.
LOSING UNIT/ACTIVITY INFORMATION:
a.
c.
Losing Unit/Activity:
Unit 1SG/Supervisor:
b.
Unit CDR/Supervisor:
Phone number:
Phone number:
Email address:
d.
Email address:
TASP Unit Coordinator:
Phone number:
Email address:
5.
FAMILY CONSIDERATIONS:
If additional space is necessary, please attach your documentation to the form)
a.
b.
c.
Housing requirements
(check one):
Pets:
Child care requirements:
Yes
No
Yes
No
Off-post housing
If yes, list pet and type:
On-post housing
d.
Spousal Employment info:
Yes
No
e.
List of local schools:
Yes
No
If yes, list type of work:
f.
g.
Contact by Unit Family Readiness Group
(FRG):
Additional comments:
If yes, list Email address:
Yes
No
PREVIOUS EDITIONS ARE OBSOLETE.
APD LF v1.00ES
DA FORM 5434, DEC 2012