USAF Contact Request Form

USAF Contact Request Form

Please fill in all of your information and your recruiter will contact you at their earliest convenience to schedule an appointment.
Name*

First NameLast Name
Date of Birth*

MonthDayYear
Date
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
What is your preferred method of contact?

CallTextEmail
Height in inches *
Weight *
What is your US citizenship status? Current Status*
What is your marital status?

SingleMarriedDivorced
Do you have any children/legal dependents?*

YesNo
Do you have a valid drivers license?*

YesNo
Highest education level*

HS JuniorHS SeniorHS GraduateSome CollegeCollege Graduate
How many college credits do you have? Completed credits
Have you ever used any illegal drugs to include marijuana?*

YesNo
Do you have any history of law violations? This includes juvenile offenses and traffic tickets.*

YesNo
If you do have any law violations, please provide a brief summary (what, when, current status)
Have you ever previously served in any branch of the military to include the Air Force?*

YesNo
Do you have any tattoos?*

YesNo
If you do have any tattoos, are any on your head, neck, face, or hands? (select all that apply)

HeadNeckFaceHandsN/A
Have you beenon ADD/ADHD medication within the last 24 months?*

YesNoI have never been diagnosed with ADD/ADHD
Have you been treated for anxiety or depression within the previous 24 months with either medication and/or counseling?*

YesNoI have never been diagnosed with anxiety or depression
Have you been prescrbed an inhaler for asthama within the last 5 years?*

YesNoI do not have asthma
Do you have anything considerable in your medical history that has been diagnosed by a medical professional? Yes No If yes, specify Medical conditions diagnosed by a doctor*
How committed are you to joining the Air Force?(1=not very interested, 10=I'm ready to join right now!)
If you qualify for the Air Force, when is the best day for you to come into my office for an interview? (Regular business hours are Monday-Friday 9am-5pm)

MonthDayYear
Date
Would you prefer a morning, afternoon, or evening appointment for your initial interview?

Morning (10am-12pm)Afternoon (12pm-2pm)Evening (2pm-4pm)
How did you find my contact information?

AirForce.comGoogleReferralSocial MediaOther
Should be Empty: