SANTA'S CASTLE ARMY REFERRAL FORM
Army Referral
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Service Member Info
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Section 1: Service Member Being Referred
Fields with an * must be completed in order for the Santa's Castle team to process your referral.
Date Referred
Service Member Rank
- Select -
PVT
PV2
PFC
SPC
CPL
SGT
SSG
SFC
WO1
CW2
CW3
2LT
1LT
CPT
MAJ
Other
Service Member First Name
Service Member Last Name
Service Member's Personal Email (DO NOT provide a .mil address)
Service Member's Personal Phone Number
Service Member's Alternate Phone Number
Brigade
Brigade
I Corps HQ
22d CSB
7th ID HQ
1-2 SBCT
2-2 SBCT
16th CAB
Regional Health Command Pacific
593rd ESC
62 Med BDE
1 MDTF
5th SFAB
555 EN BDE
189 IN BDE
1 SFG
160th SOAR
75th RGR RGT
17th Field Artillery BDE
201 E-MIB
42 MP BDE
Madigan
DENTAC
6th MP Group
8th BDE, US Army Cadet Command
66th Theater Aviation Command
404th Army Field Support BDE
USAMRD-W
Yakima Training Center
Other
Battalion
Battalion
Company
Company
List Other Unit
Marital Status
Married
Single
Is the spouse Military or Non-Military?
Military
Non-Military
Spouse Rank
- Select -
PVT
PV2
PFC
SPC
CPL
SGT
SSG
SFC
WO1
CW2
CW3
2LT
1LT
CPT
MAJ
Other
List Other Rank
Spouse First Name
Spouse Last Name
Brigade
Brigade
I Corps HQ
22d CSB
7th ID HQ
1-2 SBCT
2-2 SBCT
16th CAB
Regional Health Command Pacific
593rd ESC
62 Med BDE
1 MDTF
5th SFAB
555 EN BDE
189 IN BDE
1 SFG
160th SOAR
75th RGR RGT
17th Field Artillery BDE
201 E-MIB
42 MP BDE
Madigan
DENTAC
6th MP Group
8th BDE, US Army Cadet Command
66th Theater Aviation Command
404th Army Field Support BDE
USAMRD-W
Yakima Training Center
Other
Battalion
Battalion
Company
Company
Spouse's Personal Email (DO NOT provide a .mil address)
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Continue to Dependent Info
Section 2: Dependent Children
Accurate information on the SM's child(ren) helps us ensure we have appropriate inventory.
Infants (0-12 months)
Boys: Total in each age group
Boys: 1-2 yrs
Boys: 2-3 yrs
Boys: 3-5 yrs
Boys: 6-9 yrs
Boys: 10-13 yrs
Boys: 14-18 yrs
Girls: Total in each age group
Girls: 1-2 yrs
Girls: 2-3 yrs
Girls: 3-5 yrs
Girls: 6-9 yrs
Girls: 10-13 yrs
Girls: 14-18 yrs
Special Needs Children
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Continue to Referring Individual
Section 3: Referring Individual
Complete all information in this section for the Point of Contact for this referral.
Referring Individual Rank
- Select -
Civilian
SFC
MSG
1SG
SGM
CSM
WO1
CW2
CW3
CW4
CW5
2LT
1LT
CPT
MAJ
LTC
COL
Other
List Other Rank
Referring Individual First Name
Referring Individual Last Name
Brigade
Brigade
I Corps HQ
22d CSB
7th ID HQ
1-2 SBCT
2-2 SBCT
16th CAB
Regional Health Command Pacific
593rd ESC
62 Med BDE
1 MDTF
5th SFAB
555 EN BDE
189 IN BDE
1 SFG
160th SOAR
75th RGR RGT
17th Field Artillery BDE
201 E-MIB
42 MP BDE
Madigan
DENTAC
6th MP Group
8th BDE, US Army Cadet Command
66th Theater Aviation Command
404th Army Field Support BDE
USAMRD-W
Yakima Training Center
Other
Battalion
Battalion
Company
Company
List Other Unit
Referring Individual Email - MUST be an official military .mil email.
Referring Individual Duty Phone Number
Referring Individual Cell Phone Number
Referrer Remarks
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Continue to Signature
Electronic Signature of Referring Individual
I affirm that all information submitted is accurate to the best of my ability.
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