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