How to fill out the Unit Request for Independent

How to fill out the Unit Request for Independent
Duty Personnel (IDP) Fitness Memberships for
Private Fitness requests
Unit Information:
1. Please fill out the Unit Name, Unit Address, the Unit Point of
Contact and contact information.
Command/Unit Name:
Address:
City:
State:
Zip:
Command/Unit POC:
Phone:
Fax:
POC Email:
2. Please fill out the duty actual address if different from Unit
information.
Duty Address if different than Command Address:
Address:
City:
State:
Zip:
3. Include the Number of active duty personnel eligible to
participate; Title 10 Only. *Active Duty Title 10 with a
minimum of six months remaining at the unit and able to
meet visit requirements.
Number of active duty personnel eligible to participate (Title 10 Only): _____
4. Check box for initial request or a follow on for additional
personnel.
Initial Request
Follow On (incoming/outgoing personnel)
--------------------------------------------------------------------------------------Private Fitness Facility Information:
1 Edited 04/17/2014
5. Please fill out the number of members requesting a fitness
membership. Must be legible.
Eligibility is for Service member only, no family members are authorized
Number of Active Duty personnel requesting a fitness membership: _____
6. Fill out the Rate/ Rank/ Full Name of each service member.
Rate/ Rank/ Full Name of each Service Member:
7. Fill out Private Fitness Facility Information. No YMCA’s are
accepted if the unit chooses a Private Fitness Facility.
Name/Address/Phone number of Private Fitness facility of choice:
(All Service Members at this duty address MUST attend the same private facility)
Fitness Facility Name:
Address:
Fitness Facility POC:
City:
State:
Zip:
Fitness Facility POC Phone:
Fitness Facility POC Email:
8. Leave the YMCA section blank. This will not apply to you.
9. Please review membership requirements on Page Two
of blank IDP.
ALL IDP’S MUST HAVE TWO SIGNATURES IN
ORDER TO BE PROCESSED.
10.
Signature Line 1: must be signed by the Commander or
Officer in charge of the unit.
11.
Signature Line 2: must be signed by the Military One
Source; Military Approver. See next page for approver list.
2 Edited 04/17/2014
IDP Approval List – April 2014
Navy
Vicki Teran – All Navy approvals
[email protected]
www.navyfitness.org/fitness/armed_services_ymca_program/
Marine Corps
Davis Murphy – Marine Forces Reserve
[email protected]
Gilbert Macias – Marine Corps Recruiting Command
[email protected]
Catherine Ficadenti – Other USMC IDP Inquiries
[email protected]
www.marines.mil/unit/maforres/MFRHQ/MCCS/SemperFit/GymMemberships.aspx
Army
Brian McDonald – Army Recruiting Command
[email protected]
Carol Kowta-Herr – Other Army IDP Inquiries
[email protected]
www.usarmymwr.comrecleisure/sportsandfitness/ymca_memberships.aspx
Air Force
MSgt Elisha Abercrombie – All Air Force IDP approvals
[email protected]
www.usafsports.com
3 Edited 04/17/2014
4 Edited 04/17/2014