Dd Form 368 Request For Conditional Release
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1
2REQUEST FOR CONDITIONAL RELEASE
(Read Privacy Act Statement and Instructions on back before completing this form.)
SECTION I - REQUEST FOR RELEASE
1. SERVICE MEMBER DATA
a. NAME (Last, First, Middle Initial)
b. PAY GRADE
c. SSN
d. SERVICE COMPONENT
e. CURRENT UNIT/
f. ADDRESS
COMMAND
(1) STREET
(2) CITY
(3) STATE
(4) ZIP CODE
2. RECRUITING OFFICE ADDRESS
a. STREET
b. CITY
c. STATE
d. ZIP CODE
3. ACKNOWLEDGEMENT OF SERVICE MEMBER
a. I request a conditional release to process for entrance into another component of the Military Service. If I am a member of the National Guard or
Reserve, I understand that I must attend all scheduled training until such time as I am enlisted or appointed into another Service. I also understand that
I am to keep my current commander informed of any change in my status.
b. OFFICER MEMBER ONLY. I hereby tender my resignation from the
(losing component); request that it be accepted
contingent upon actual appointment or enlistment in the
(gaining component), and be effective the day preceding the
date of my acceptance of appointment or enlistment.
c. ENLISTED MEMBER ONLY. I understand I will be discharged from my current status effective the day preceding the date of my enlistment or
appointment.
d. MEMBER SIGNATURE
e. DATE SIGNED
.
4. RECRUITER REQUEST FOR CONDITIONAL RELEASE
a. Request conditional release to enlist/appoint member into the
(Service/Component).
b. NAME OF RECRUITER (Last, First, Middle Initial)
c. SIGNATURE
d. DATE SIGNED
e. TITLE
SECTION II - APPROVAL/DISAPPROVAL
5. (X as applicable)
a. APPROVED. Individual is recommended and conditional release is granted. The release is valid until
.
b. DISAPPROVED. Release is not granted. (Explain in "Remarks.")
6. AUTHORIZING OFFICIAL
a. NAME (Last, First, Middle Initial)
b. TITLE
c. TELEPHONE NUMBER
d. ADDRESS
(Include area code)
(1) STREET
(2) CITY
(3) STATE
(4) ZIP CODE
e. SIGNATURE
f. DATE SIGNED
SECTION III - NOTIFICATION OF ENLISTMENT/APPOINTMENT ACTION
.
7. The member was administered the oath of enlistment or appointment into
THIS FORM AND A COPY OF THE OATH MUST BE RETURNED TO THE ADDRESS IN ITEM 6.d. TO EFFECT THE MEMBER'S DISCHARGE
OR WITHDRAWAL OF FEDERAL RECOGNITION.
8. CERTIFYING OFFICIAL
a. NAME (Last, First, Middle Initial)
b. TITLE
c. UNIT/COMMAND
d. TELEPHONE NUMBER
e. ADDRESS
(Include area code)
(1) STREET
(2) CITY
(3) STATE
(4) ZIP CODE
f. SIGNATURE
g. DATE SIGNED
DD FORM 368, NOV 94
PREVIOUS EDITION IS OBSOLETE.
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