ࡱ> 5@ .bjbj22 <XXJ.......dHHHH4|ddjlXXXX7&] X$ Rr"E.37..XX$   .X.X  $ /|..AX `8 dH-:]\:0j/#g#$ABV....#.Aa>, $(aaaddHddHFAX COVER SHEET TO: ECI (334) 416-4679 or DSN 596-4679 FROM:  FORMTEXT       Name / CAP Grade FORMTEXT      Address FORMTEXT      ,  FORMTEXT     FORMTEXT      - FORMTEXT     City, State, Zip Code REGISTAR: Please process the attached ECI Form 23. ECI ENROLLMENT APPLICATION (TYPE or PRINT clearly. Fill out in accordance with instructions in the ECI Catalog)PRIVACY ACT STATEMENT 1. AUTHORITY: 44 USC 3101; 3101; 10 USC 8012; EO 9397. 2. PRINCIPLE PURPOSE: Used for individuals to provide information to ECI for enrollment in a specific correspondence study course. 3. ROUNTINE USE: To provide ECI course enrollment. 4. DISCLOSER: Voluntary. However, if information is not provided, enrollment cannot be accomplished.1. ECI COURSE NUMBER 2. SOCIAL SECURITY ACCOUNT NUMBER3. IDENTITY CODE/ CATEGORY000013 FORMTEXT   FORMTEXT   FORMTEXT   FORMTEXT   FORMTEXT   FORMTEXT   FORMTEXT   FORMTEXT   FORMTEXT  74. NAME (First Initial, Second Initial, Last Name)REASON FOR FORMTEXT   FORMTEXT   FORMTEXT       ENROLLMENT - CODES6. PAY GRADE7. TCO PHONE (Autovan)L FORMCHECKBOX  MANDATORY FORMDROPDOWN N/" " $ . 0 4 6 J L N R T V X l n p z | ~ zmjhHCJ UjbhHCJ UjhHCJ UjhHCJ UmHnHujhHCJ U hHCJ jhHCJ UhH!jhH5CJ UmHnHujhH5CJ UjhH5CJ U hH5CJ hH5CJ() "v !t!t!!v:u:v:Yu:2kd$$IflF4 la2kdD$$IflF4 la2kdt$$IflF4 la$If$a$ .  : k w  4 6 | ~  üεεΩȩȩȩȩȩȟȟjhHCJUmHnHujhHCJUjhHCJU hHCJ hHCJ hH5CJ hH6CJ hH5 hHCJ$hH hHCJ jhHCJ UmHnHujhHCJ Uj5hHCJ U3   : v:u:!v:!!t!v:t!^ $$Ifa$2kd$$IflF4 la2kd$$IflF4 la$If 8 ~ t!^t!^x!i ^^[^[^$If2kd$$Ifl J"4 la $$Ifa$ $$Ifa$2kdL$$Ifl J"4 la @ B b v:$IfZkd$$IflvF  ? 2    4 la      " 6 8 : < > B D X Z \ ^ ` b d x z | ~ ͢{j0hHCJUjhHCJUjphHCJUhHjhHCJUjhHCJUjPhHCJU hHCJ$jhHCJUmHnHujhHCJUjhHCJU hHCJ0   vxDFHbd¼¼¼µ„jhHCJUjhHCJUjdhHCJUjhHCJU hH6CJ hHCJ hH5CJhHjhHCJUmHnHujhHCJU hHCJjhHCJU hHCJ$3   x(FnnA^[^^[^[^Ekdj$$Ifl0 24 la & F$If $If`Ff $IfFHdmci ^]^][^$If $If`kdL$$IflֈZ ga24 la**** *&*(***F*H*`****++J+L+N+l++++,,ĵˮۚۈہzslez_e hHCJ$ hH5CJ$ hH5CJ hH>*CJ$ hH>*CJ hH6CJ"jhHhH5CJUjhH5CJUU hHCJ hH5CJ,jhH5CJU hH5CJjhH5CJUhH hH5CJ hHCJjhHCJUjxhHCJU%**F*H*^i [^[^>Xkd $$IflF  ? 1    4 la$If $$Ifa$Xkd$$IflF  ? 1    4 laA N FORMCHECKBOX  VOLUNTARY8. ADDRESS (OJT enrollee use address of Unit Training Office)10. COURSE TITLENM Wing Headquarters CAP Senior Officer CourseP.O. Box 5069 Kirtland AFB, NMSIGNATURE AND TITLE OF APPROVING OFFICIAL The applicant has been briefed on the enrollment policy and is eligible for enrollment in this course.ZIP CODE87185-5069SIGNATUREZIP CODE/SHRED OF TEST CONTROL OFFICE 8718550697TITLE Commander, SWR-NM-012ECI FORM 23 PREVIOUS EDITION WILL BE USED *U.S. GPO 1993 737-906 SEP 82 H****+L+N+^^^;Ekd$$Ifl00 4 la d $If] td $If]Ekd$$Ifl00 4 la $If]$If]`N+l++++j,,,,-hC^^^^aS^S$If]`Ekd$$Ifl00 4 laV$If]^V` $If] & F$If] HtdH$If]` Htd $If]` ,,,,,----- - -------- -"-&-8-:-<---------------------------... hHCJ hHCJ$ hH5CJ hH5CJ$ hH5CJhH5--- ----- -$-&-:-<----^^^^$If]^ & F$If]Ff2 $If]$If]`-----------------.~~~~~~{{{{{{!^Ff] $If]$If]`Ekd^$$Ifl00 4 la...!^!v:/ =!"#$%tD"Text2Z$$If!vh5#v:V l5/ 4atD!Text1L$$If!vh5#v:V l54aZ$$If!vh5#v:V l5/ 4atDText3tDText4_DText5_DText6Z$$If!vh5#v:V l5/ 4aZ$$If!vh5#v:V l5/ 4aZ$$If!vh5L"#vL":V l5J"/  4aZ$$If!vh5L"#vL":V l5J"/  4a$$If!vh5A 553#vA #v#v3:V lv5? 552/  4a`DText13`DText14`DText15`DText16`DText17`DText18`DText19`DText20`DText21$$If!vh5l5l5l5l5l55w5p5 p5 p5 p5 p5 p5 p5p5p5p5p5F5F5#vl#v#vw#vp#vF#v:V l 5l55w5p5F5/ /  / / / / / / / / / / / / / /  4a_kd$$IflpHb I ) yY95 lllllwpppppppppppFF TTTT4 lap$$If!vh553#v#v3:V l552/  4aDText23 UppercaseDText24 Uppercase`DText25*$$If!vh55g55a553#v#vg#v#va#v#v3:V l55g55a552/ / / / / / / /  4atDeCheck1$$If!vh5A 553#vA #v#v3:V l5? 551/ /  4aDf Dropdown1 E-1N-1FOFO-1FO-2O-1O-2O-3O-4O-5O-6C-1C-2C-3C-4C-5C-6tDeCheck2$$If!vh5A 553#vA #v#v3:V l5? 551/ /  4ap$$If!vh55#v#v:V l55/  4ap$$If!vh55#v#v:V l55/  4a$$If!vh55#v#v:V l55/ / / 4a$$If!v h5v5\5\5\5\55Y5Y5 Y5 Y5 Y5 Y5 #vv#v\#v#v Y#v :V l5v5\55 Y5 /  / / / 4a*kd$$Ifl" j"~s % ~ 0 v\\\\YYYYYY44444 lap$$If!vh55#v#v:V l55/  4a$$If!vh5V5V5V5V5V5V55S5 S5 S5 S5 S5 S5 #vV#v#v S#v :V l 5V55 S5 / / / / / / / / / / / / 4aUkd$$Ifl8DF2 + ~ $ VVVVVVSSSSSS 88884 la8@8 Normal_HmH sH tH DAD Default Paragraph FontVi@V  Table Normal :V 44 la (k@(No List J<J;Ufg{|:?Sbcegikmop<GHXYij~#$cuv5tu~BIL00000 0 0 0 0 0 0 0 0 0 00000 0 00 0 0 0 00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0  0 0 0 0 0 0 0 00 0 0 0 0 0 0 0 000 0 0 0 000 04 00 00000000 04 0 0 0 0 0 0 0 0 0 0 0 0 0 0  00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 00 0   ,.  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AMSgsyp|~HTVYegjv|JFFFFFFFFFFFFFFFFFFG$S G 8@0( Dk6 B S  ?JText2Text1Text3Text4Text5Text6Text13Text14Text15Text16Text17Text18Text19Text20Text21Text23Text24Text25Check1 Dropdown1Check2BhqIZkL TzWh}Lo!(!^!,,L00L:*urn:schemas-microsoft-com:office:smarttagsStreet;*urn:schemas-microsoft-com:office:smarttagsaddressB*urn:schemas-microsoft-com:office:smarttagscountry-region9*urn:schemas-microsoft-com:office:smarttagsplace ~L$,v>DL333;g|p<H~$cuBIL~L John GrasshamY@yh..r0&@$D{'Qyhy5s$gzr0 @hV^V`56>*CJOJQJo(. @hh^h`56>*CJOJQJo(. @hh^h`56>*CJOJQJo(. @hV^V`56>*CJOJQJo(. @hh^h`56>*CJOJQJo(. @hh^h`56>*CJOJQJo(. &@..Y@y5sgzD{'QH;Ufg{|?bcegikmop<GHXYij~#$cuvtu~IL@6Q@J``@` ``*UnknownGz Times New Roman5Symbol3& z Arial"h\xax4 4 !24GG7H)?HECI Enrollment Application John Grassham John Grassham$      Oh+'0 ~ 0< X d p |ECI Enrollment ApplicationCI John Grassham AohnECI_Enrollment_ApplicationJohn Grassham_A1hnMicrosoft Word 10.0@^в@@@ d@ d4Gp|VT$m '>  } ."System Qr0M  -@Times New Roman- "2  xFAX COVER SHEET<IHHNHCH8NCCC 2  x z5 2 7 x z6@Times New Roman-2  xTO:5> 2 P x z& 2 v x z2 *  xECI (334) 4165:(((((( 2  x-z%2 ! x4679 or DSN 596((((($:,:((( 2  x-z2  x4679(((( 2 C x z+-2  xFROM:20:>L 2  x zY 2 * x 2 * x ( 2 R x 2 R x z( 2 z x 2 z x ( 2  x 2  x z( 2  x 2  x (@Times New Roman- 2  x #2 7/xName / CAP Grade$%  "# $ 2 7x - @ !q-@Times New Roman- 2 /x 2 /x z( 2 Wx 2 Wx ( 2 x 2 x z( 2 x 2 x ( 2 x 2 x z( 2 x z(-2 /xAddress# 2 x z- @ !q-- 2 $/x 2 $/x ( 2 $Wx 2 $Wx z( 2 $x 2 $x ( 2 $x 2 $x z( 2 $x 2 $x (2 $x,  2 $x 2 $x z( 2 $Gx 2 $Gx ( 2 $ox  2 $x 2 $x z( 2 $x 2 $x ( 2 $x 2 $x z( 2 $x 2 $x ( 2 $#x 2 $#x z( 2 $Kx-z 2 $ex 2 $ex ( 2 $x 2 $x z( 2 $x 2 $x ( 2 $x 2 $x z( 2 $x z)-+2 i/xCity, State, Zip Code"     ! 2 ix z- @ !q8- 2  x z@Times New Roman-+2  xREGISTAR: Please proc<7B27A<2((#(--(72 F xess the attached ECI Form 23.(##-((((-(,7<2-E-- 2   x z( 2 h x z(@Times New Roman-22 i xECI ENROLLMENT APPLICATION!$ !$$'"!0!$! $!$%!'$ 2 Mi x z@Times New Roman- 2 Ti x(TYPE or PRINT clearly. Fill out in accordance with instructions in the ECI Catalog)                       - 2 ai x z- @ !h~f-- @ !h~ -@Times New Roman- +2 i xPRIVACY ACT STATEMENT  % 2 i x z@Times New Roman- 2 ;i x1.  - 2 ; i xAUTHORITY- V2 ;2i x: 44 USC 3101; 3101; 10 USC 8012; EO 9397. 2.           - %2 ;i xPRINCIPLE PURPOSEM - 2 ; i x: Used for   /2 ;mi x individuals to provide        - 2 iSi xinformation to ECI for enrollment in a specific correspondence study course. 3. )                 - 2 i i xROUNTINE USE- 12 i4i x: To provide ECI course     - %2 i xenrollment. 4. r   - 2  i xDISCLOSERU- 2 gVi x: Voluntary. However, if information is not provided, enrollment cannot be accomplis                  2 i xhed. - 2  i x z- @ !f-- @ !i-- @ ! -- @ !f-- @ ! -- )2 i6x1. ECI COURSE NUMBER   &- 2 `i6x z - 2 ji6x z- >2 S"9,x2. SOCIAL SECURITY ACCOUNT NUMBER    &- 2 9,x z- (2 I/ x3. IDENTITY CODE/ R   2  / x z- 2 I/ x CATEGORY - 2 m / x z- @ !f-- @ !i-- @ !6-- @ !6-- @ !9-- @ !,-- @ !,-- @ !/-- @ ! -- @ !^f-- @ !^6-- @ !^,-- @ !^ -@Times New Roman- 2 =ix0z- 2 =ix z-- 2 =x0z- 2 =x z-- 2 =9wx0z- 2 =Wwx z-- 2 =zx0z- 2 =zx z-- 2 =-x1z- 2 = -x z-- 2 =J0x3z- 2 =h0x z- 2 X6x z-- 2 =S9x 2 =S9x - 2 =q9x -- 2 =x 2 =x z- 2 =x z-- 2 = Jx 2 = Jx - 2 =)Jx - 2 XgMx -- 2 =x 2 =x z- 2 =x z-- 2 =^x 2 =^x - 2 ==^x -- 2 4{ax - 2 =x 2 =x z- 2 =x z-- 2 =3rx 2 =3rx - 2 =Qrx -- 2 =ux 2 =ux z- 2 =ux z-- 2 =*x 2 =*x - 2 = *x - 2 XG-x -- 2 =M x7- 2 =M x - 2 Xj P x -- @ !f-- @ !Xi-- @ !-- @ !-- @ !X-- @ !-- @ !-- @ !X-- @ !w-- @ !w-- @ !Xz-- @ !-- @ !-- @ !X-- @ !--- @ !--- @ !i0-- @ !-- @ !-- @ !6-- @ !Y9-- @ !-- @ !-- @ !Y-- @ !-- @ !-- @ !Y-- @ !J-- @ !J-- @ !-- @ !-- @ !Y-- @ !-- @ !-- @ !Y-- @ !^-- @ !^-- @ !-- @ !-- @ !Y-- @ !-- @ !-- @ !Y-- @ !r-- @ !r-- @ !Yu-- @ !-- @ !-- @ !Y-- @ !*-- @ !*-- @ !-- @ !-- @ !-- @ !M -- @ !M -- @ ! -- @ !gf-- @ !g-- @ !g-- @ !gw-- @ !g-- @ !g--- @ !g-- @ !g6-- @ !g-- @ !g-- @ !gJ-- @ !g-- @ !g-- @ !g^-- @ !g-- @ !g-- @ !gr-- @ !g-- @ !g*-- @ !g-- @ !gM -- @ !g -- 2 i,x4. NAME &- 2 ,i,x - L2 6+i,x (First Initial, Second Initial, Last Name)          - 2 i,x - 2 I/ x5.  @"Arial- 2 q/ x 2- 2  / xREASON FOR - 2  / x - @ !nf-- @ !Xni-- @ !n-- @ !Xn-- @ !n-- @ !Xn-- @ !nw-- @ !Xnz-- @ !n-- @ !Xn-- @ !n--- @ !in0-- @ !n-- @ !n-- @ !n6-- @ !Yn9-- @ !n-- @ !Yn-- @ !n-- @ !Yn-- @ !nJ-- @ !YnM-- @ !n-- @ !Yn-- @ !n-- @ !Yn-- @ !n^-- @ !Yna-- @ !n-- @ !Yn-- @ !n-- @ !Yn-- @ !nr-- @ !Ynu-- @ !n-- @ !Yn-- @ !q,-- @ !n*-- @ !n--- @ !n0-- @ !n-- @ !n-- @ !nM -- @ !nP -- @ !n -- @ !n -- @ !n -- @ !.rf-- @ !.r,-- @ !.r -- 2 ix 2 ix z- 2 ix z- 2 0x z-- 2 M3x 2 M3x - 2 k3x - 2 x -- 2 ,x 2 ,x z 2 4,x 2 4,x  2 R,x 2 R,x z 2 p,x 2 p,x  2 ,x 2 ,x z- 2 ,x z-- 2 I / x  - 2  / xENROLLMENT % 2  / x-z 2  / x z- 2 I / x 2 / xCODES- 2 - / x z-- @ !f-- @ !ni-- @ !-- @ !-- @ !0-- @ !0-- @ !n3-- @ !-- @ !-- @ !-- @ !-- @ !0-- @ !,-- @ ! -- @ !gf-- @ !g-- @ !g0-- @ !g-- @ !g-- @ !g,-- @ !g -- 2 3 i6x6. PAY GRADE  - 2 3i6x z- "2 2S9,x7. TCO PHONE    - 2 2 9,x(Autovan)H   - 2 2(9,x z- 2 2I/ xLzx /- x /'--7h--'-  2 2/ x - 2 2 / xMANDATORY&- 2 2 / x z- @ ! f-- @ !n i-- @ ! -- @ !V -- @ ! 0-- @ !n 3-- @ ! -- @ !U -- @ ! -- @ !: -- @ !6-- @ ! 6-- @ ! 9-- @ ! ,-- @ !  -- @ !.f-- @ !.6-- @ !.,-- @ !. -@Times New Roman-----x6i-x6i2 i6x ''@Times New Roman-  2 i6x z7- 2 wS9,xN/A+*- 2 w9,x z8- 2 eI/ x z 2 I/ xNzx /x /'--rj---rjrj-'-  2  / x VOLUNTARY  2  / x z- @ !=f-- @ !=i-- @ !=6-- @ !=9-- @ !=,-- @ != -- @ ![Af-- @ ![A6-- @ ![A,-- @ ![A -- 2  ix8. ADDRESS   - V2 v2ix(OJT enrollee use address of Unit Training Office)             - 2 ix z%2  x10. COURSE TITLE/   2 [ x z- @ !f-- @ !i-- @ !6-- @ !9-- @ !-- @ !-- @ !]-- @ !,-- @ !/-- @ ! -- @ !.f-- @ !.-- @ !. -- )2 . ixNM Wing Headquarters+58* 2 . ix z- @ !5 -- 2 . ix z-xi'@Times New Roman-12 .  xCAP Senior Officer Course++%!!/+!@Times New Roman- 2 .  x z-- @ !xf-- @ !x-- @ !x -- 2  ixP.O. Box 5069 !+' 2 ix z- @ !  - 2 ix zxi'- #2  ixKirtland AFB, NM*, (+5- 2  Iix z.xi'- 2 n  x11.  - 2 n % x z- =2 n C! xSIGNATURE AND TITLE OF APPROVING      2 n ^  x z%2  x OFFICIALe  2  x z- a2 9 x The applicant has been briefed on the enrollment             2 Q  x z^2 7 x policy and is eligible for enrollment in this               - 2 % ? xcourse.  - 2 %  x z.- @ !F f-- @ !F -- @ !*F -- @ !F -- @ !J f-- @ !J -- @ !J -- 2 X ixZIP  - 2 ixCODE- 2 ix z-- 2 k [x8z- 2 k ;[x z-- 2 k t^x7z- 2 k ^x z-- 2 k  x1z- 2 k  x z-- 2 k " `x8z- 2 k @ `x z-- 2 k ycx5z- 2 k cx z- 2 x-z 2 x z-- 2 k 6 sx5z- 2 k T sx z-- 2 k vx0z- 2 k vx z-- 2 k  x6z- 2 k  x z-- 2 k 9#vx9z- 2 k W#vx z- 2 yx z-- 2 X   xSIGNATURE- 2 X  x z,- @ !0 f-- @ !0 -- @ !0 -- @ !T0 -- @ !3 [-- @ !0 [-- @ !T0 ^-- @ !3 -- @ !0 -- @ !T0 -- @ !3 -- @ !0 -- @ !T0 -- @ !3 `-- @ !0 `-- @ !d0 c-- @ !3 -- @ !0 -- @ !S0 -- @ !3 -- @ !0 -- @ !S0 -- @ !3 s-- @ !0 s-- @ !S0 v-- @ !3 -- @ !0 -- @ !T0 -- @ !3 -- @ !0 -- @ !S0 #-- @ !3 v-- @ !0 v-- @ !S0 y-- @ !0 -- @ !*0 -- @ !0 -- @ !g4 f-- @ !g4 -- @ !g4 [-- @ !g4 -- @ !g4 -- @ !g4 `-- @ !g4 -- @ !g4 -- @ !g4 s-- @ !g4 -- @ !g4 -- @ !g4 v-- @ !g4 -- @ !g4 -- 2 ix9.  - 2 ix z2- C2 %ixZIP CODE/SHRED OF TEST CONTROL OFFICE        2 Vix z 2 ix z 2  x z- @ ! f-- @ ! -- @ ! -- @ !T -- @ ! 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GA ECI Enrollment Application Title  !"#$%&'()*+,-/0123456789:;<=>?ABCDEFGHIJKLMNOPQRSTUVWXYZ[\]^_`abcdefghijklmnopqrstuvwxyz{|}~Root Entry F@k dData 1Table.(#WordDocument<SummaryInformation(@P~DocumentSummaryInformation8CompObjj  FMicrosoft Word Document MSWordDocWord.Document.89q