This form has moved to https://www.marineofficer.org/screeningform
Name
First Name
Last Name
Email
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Cell Phone Number
-
Area Code
Phone Number
Current Full Time Student?
Yes
No
Have you already attained an undergraduate degree?
Yes
No
University Name
Major/Minor
Projected Graduation or date graduated
Cumulative GPA
SAT (math and reading) score (if any)
ACT Score (if any)
LSAT Score (Law applicants only)
Are you a U.S. citizen (required)
Yes
No
What is your race/ethnicity
What is your gender?
Male
Female
Date of birth
-
Month
-
Day
Year
Date
Place of birth
Height
E.g. 5'10" (feet and inches)
Weight
Weight in pounds
Has a doctor ever told you that you have asthma?
Yes
No
Have you ever used an inhaler?
Yes
No
Do you have any known allergies?
Yes
No
Are you currently on any prescription medications?
Yes
No
Do you have any known diseases?
Yes
No
Have you ever been hospitalized?
Yes
No
Have you ever had a surgery?
Yes
No
Do you have any pins, plates, or screws in your body?
Yes
No
Do you have 20/20 vision uncorrected?
Yes
No
Do you have any other vision problems?
Yes
No
If yes, explain:
Do you have any other medical conditions that may disqualify you from military service?
Yes
No
Do you have any tattoos or brands?
Yes
No
Do you have any piercings?
Yes
No
If yes, are any of your piercings gauges?
Yes
No
Have you had any traffic tickets?
Yes
No
Have you ever been arrested?
Yes
No
Have you ever used any illegal drugs?
Yes
No
Are you married?
Yes
No
Do you have any children?
Yes
No
Have you ever served in the military?
Yes
No
How many times a week do you exercise?
How many pull-ups can you do?
How long would it take you to run 3 miles?
How many crunches can you do in 2 minutes?
Why do you want to be a Marine Officer?
Father's Occupation
Mother's Occupation
Your Occupation
What do you do for fun?
Military heritage in family
How did you hear about the Marine Corps Officer program?
Please select your top 3 choices that interest you the most about becoming a Marine Corps Officer.
Challenge
Professional Development and Personal Growth
Patriotism
Pride and Honor of a Marine Commission
Post Graduate Education
Travel and Adventure
No Obligation until Graduation
Equal Opportunity
Career Variety
Physical Fitness
Leadership Management and Training Experience
Tuition Assistance
Financial Security and Benefits
The Marine Corps offers many different programs to include ground contract, guaranteed flight school seats and law contracts for qualified applicants, which program are you primarily interested in? (Air, Ground, Reserve Ground, or Law)
Any Questions?
Should be Empty: