ALC (BNCOC) deferment - how to fill out the 4187

Does anyone know how to fill out a 4187 for a medical deferment from ALC (what was BNCOC)? My report date is 23 March - I've been struggling for the last couple months just to figure out who the heck is even paying for my school, etc. That's not the main issue - the main issue is I have had back and shoulder issues for 2-3 years now and finally able to get it checked out but it's gotten worse and I can't pass the run on my PT test right now (I know it's pathetic not to be able to pass the run when you get 20:30 so I guess I'm a dirtbag NCO because I'm hurt and can't run fast...whatever).

The main thing is I work under STRATCOM but in Ft Meade and we're under an Air Force command in our section and we're not admin attached to an Army unit (because they and STRATCOM couldn't agree on who would be in charge of what) so I had to go through HRC to get funding. But then my branch manager told me I have to do a 4187 that he would send to NCOES to get me out of my class but it has to be signed by O6 or higher. That's no issue but I just am not sure how to fill it out and getting little guidance. Had I known I'd be in this situation, I would've stayed at my old unit until I was done with ALC but I reenlisted in Iraq. I still don't even have my orders from HRC and was told "sometime next week" (15-19) but I don't even have a passing PT test. The other SSG here is trying to get it so I take another one (my third since the 5th) on the 19th but I just took an assessment Tuesday and no way will I be at passing with all the medical issues.

If anyone knows how to do a 4187 for medical deferment please let me know and my email is lasparks@yahoo.com. Thanks.
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