Name *

Rank/ Rate *

Phone Number *

### - ### - ####

Enter best contact number

Email *

Sex *

Male

Female

Required for Berthing rooms.

Berthing Information

Please ensure that the Check-in day is the first day you will require berthing.

Check-IN Date/Time *

MM / DD / YYYY

Check-OUT Date/Time *

MM / DD / YYYY

Number of nights *

Total number of nights requesting berthing.

IDT Drill Location *

Berthing Acknowledgement:

All fields are required.

Agreements: *

I agree that my home of record is more than 50 miles from my IDT site.

I understand that I shall submit my berthing request by the 15th of the month prior to my IDT Drill date.

I understand that I shall contact SSP RFRS berthing coordinator to cancel and any cancelled berthing less than one (1) week will not be rescheduled.

I agree and understand that if I fail to cancel at least 48 hours prior to my check-in date I may be held responsible for the cost.

I agree that I shall notify SSP RFRS berthing coordinator two (2) weeks prior to my IDT Drill date to re-schedule my berthing request.

I understand that the only authorized re-scheduling of any berthing request will be made due to operational training needs.

I agree and understand that no modifications can be made to a confirmed berthing other than a cancellation that is provided to SSP RFRS berthing coordinator.

I agree and understand that I, as the SELRES member, shall not contact the hotel for any reason related the confirmed berthing and/or my IDT berthing.

I agree, that I shall on check-out day from the hotel, sign the hotel invoice and ensure that it is sent via scanned email or fax to SSP RFRS berthing coordinator. Fax # 305.415.7079

Final Agreement:

All fields are required.

Signature Confirmation *

By entering/typing in my full name below, I am agreeing to terms set forth above and that my typed full name is considered an official signature.

I furthermore agree that I have read and understand the Reserve Policy manual COMDTINST M1001.28A Section Chapter 2.B.6. "Berthing while on Inactive duty orders."

Name *

First Last

Full name needs to be entered

Date *

MM / DD / YYYY