Page:Implementation of Combatant Status Review Tribunal Procedures for Enemy Combatants detained at Guantanamo Bay Naval Base, Cuba.pdf/20

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1. Name (Last, First MI) ________________________________________ 2. Rank/Grade ____________________ 3. Date of Rank ____________________ 4. Service __________ 5. Active Duty Service Date _________________ 6. Desig/MOS ____________________7. Date Current Tour Began: ______________________________ 8. Security Clearance Level ________________________________ 9. Date of clearance: ____________________ 10. Military Awards/Decorations: __________________________________________________________________ ____________________________________________________________________________________________ 11. Current Duty Position ________________________________ 12. Unit: ____________________________ 13. Date of Birth ____________________________ 14. Gender _____ 15. Race or Ethnic Origin ______________ 16. Civilian Education. College/Vocational/Civilian Professional School: ___________________________________ 17. Date graduated or dates attend (and number of years), school, location, degree/major: ____________________ ____________________________________________________________________________________________ ____________________________________________________________________________________________ 18. Military Education. Dates attended, school course title. _____________________________________________ ____________________________________________________________________________________________ ____________________________________________________________________________________________ 19. Duty Assignments. Last four assignments, units, and dates of assignments. _____________________________ ____________________________________________________________________________________________ ____________________________________________________________________________________________

20. Have you had any relative or friend killed or wounded in Afghanistan or Iraq? _____________________ Explain. ____________________________________________________________________________________________ ____________________________________________________________________________________________ ____________________________________________________________________________________________ Enclosure (6)