US Navy Interest Survey
***Due to increasing demands for high quality men and women in the United States Navy, I appreciate your cooperation in answering the questions below. Only a few moments of your time will be required.***
Name
*
First Name
Middle Name
Last Name
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Birthday
*
-
Month
-
Day
Year
Date
Approximate Height
:
Feet
*
Inches
*
Approximate Weight
:
Pounds
*
Are you a High School Graduate?
*
Yes
No
Currently Enrolled
GED
What type of Career Fields interest you?
Aviation
Computers/Communications
Electronics
Administration
Engineering
Nuclear Engineering
Special Programs (SEAL, Diver, Air Rescue, EOD, SWCC)
Medical/Dental
Construction
Other
What benefits may be of interest to you?
Free Medical/Dental Care
20yr Retirement
Job Security
College Credits
0% Down VA Home Loan
World Travel
30 Days Annual Paid Vacation
100% Paid Education (Post 9-11/GI Bill, Tuition Assistance)
OJT (On The Job Training)
Pathway to Citizenship
Other
Would you be willing to make an investment of thirty minutes of your time to discuss the opportunities and benefits available to you in the Navy?
Please Select
YES
NO
UNSURE
Do you know anyone that is serving or has served in the US Armed Forces?
Please Select
YES
NO
Submit
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