U.S. Air Force Questionaire
Name
First Name
Last Name
Date of Birth
-
Month
-
Day
Year
Date
Phone Number
-
Area Code
Phone Number
Email
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
What is your highest level of education completed?
Still in High School
High School
20-44 College Credits
45+ College Credits
Associate’s Degree
Bachelor’s Degree
Other
What’s your citizenship status
U.S. Citizen
Permanent Resident
Other
What is your height?
What is your current weight?
What is your marital status?
Single
Married
Divorced
How many Children
0
1
2
3+
Have you ever had any law violations, regardless of the outcome?
Yes, simple traffic tickets
Yes, but more than simple traffic tickets
No
Any history of Drug Usage
Yes, marijuana
Yes, other than marijuana
No
Do you have any tattoos, body modifications, piercings?
Yes
No
Do you have any scars from accidents or surgery? If yes, what caused the scar and what kind of medical care did you receive?
No
Yes- Cause & Medical Care Received
Other
Any medical issues? Check all that apply
ADD/ADHD
Asthma
Broken Bones
Surgeries
None
Have you ever taken a full ASVAB?
No
Yes, in High School
Yes, with another branch
Have you ever served in the Armed Forces in any capacity?
Yes
No- What branch? Active Duty/Guard/Reserve
Do you know anyone who wants to join the U.S. Air Force or would benefit from speaking with a Recruiter? If yes, please provide name and contact #:
Submit
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