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Want more information mailed to you about becoming a Soldier in the U.S. Army? Fill out the form below (some fields are optional) and you will receive a brochure within one to two weeks. Voluntary information shared with the U.S. Army will not be shared with any other party and will be used for recruiting purposes only. For more information, please read our Privacy & Security Notice.

Please fill out all required information, noted with an asterisk (*)

Personal Information
* First Name:
Middle Initial:
* Last Name:
Suffix:
* Date of Birth:
* Gender:  Male    Female  
Current Address
* Street Address:
Street Address 2:
* City:
* State:
* ZIP Code:
Contact Information
Area Code:
Phone Number: eg. 555-5445
Type of Phone:
Best Time to Call:
May we contact you via E-Mail?   Yes
E-mail Address:
  * Either phone or email is required

Citizenship
* What is your U.S. citizenship status?
     U.S Citizen   Legal Resident   Neither

Interest Areas
Would you like information about:
  
Army
Army Reserve
ROTC
Are you interested in any of the following programs?
       Warrant Officer Flight Training   Band
       Officer Candidate School   Linguist
       Special Forces  

Education
Are you currently enrolled in school?
     Yes    No
What is the highest grade you have completed?
    High School: 9 10 11 12
    College: 1 2 3 4 more than 4
College attending/planning to attend:
 
State:
College: 

Family Status
What is your marital status?
     Single    Married    Divorced
Number of Dependents  

Physical Characteristics
What is your height?   feet     inches
What is your weight?   lbs

Military History
Have you ever served in the military before?
     Yes   No  

Ethnicity
What is your ethnic background?
         Asian   Native American
         Black/African American   White/Caucasian
         Latino/Hispanic   Other
         Used for statistical purposes only

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