United States Air Force & Space Force Questionnaire
First name
*
Middle name
Last name
*
Phone number and service provider
*
Street Address
City/State/Zip code
Email address
*
Date of birth
*
Place of birth
Height and Weight
*
Gender
*
Male
Female
Racial category
American Native/ Alaskan Native
Asian
Black
Native Hawaiian or other Pacific Islander
White
Ethnic category
Hispanic or Latino
Not Hispanic or Latino
Hair and eye color?
How did you find me?
School/ Event
Internet
Social media
Perpetuation (friend, family, influencer, etc)
Other
Do you have the following original or certified copies ( check all that apply)
Driver’s license
Driver’s permit
Birth certificate
Social security card
High School diploma
College transcript
Marital Status
Single
Married
Divorced
Other
Number of dependents
Are you expecting
Yes
No
Citizenship Status
U.S Citizen
Permanent Resident
Other
Green card expiration date (if applicable)
Education (check all that apply)
GED
High School
Some college
Associates
Bachelors
Higher level
Name of High School/ Grad year
Name of College/ Grad year
Have you ever served in the military? If so which branch? RE code?
Have you ever taken the following
APT
PICAT
ASVAB
If you took any of the above, what when did you take them and what were your scores?
Do you have any of the following medical history? ( be advised your medical history and prescription records will be reviewed for the last 7 years if enlisting. Additionally, COVID vaccines are a requirement and you must be vaccinated or willing to receive the vaccination.)
Have you ever had asthma or used an inhaler?
Have you ever been hospitalized or had surgery
Do you have any scars?
Do you have any allergies?
Have you had any medications prescribed in the past 7 years to include birth control?
Do you wear braces or a retainer?
Do you wear glasses?
Have you ever been diagnosed with ADHD, depression, anxiety, stress, or ever considered suicide?
Do you have any medical conditions, prescriptions, or history not listed above?
Please briefly explain any yes answers listed above.
Do you have any tattoos, piercings, or body modifications?
Yes
No
If answered yes please briefly explain how many, what they are, and where they are.
Have you ever used any illegal drugs to include marijuana?
Yes
No
Have you ever been cited, charged, or held by any law enforcement agencies to include minor traffic violations and speeding/parking tickets? Regardless if it was closed, dismissed, expunged, etc.
Yes
No
Please briefly explain any yes answers
Career interests (check all that apply)
Air Force
Space Force
Mechanical
Electrical
Trade careers
Computers/IT
First responders
Admin
Aviation
Medical
Special Warfare
Intelligence
Linguist
Honor Guard
Not sure/ other
Which of these benefits the Air Force offers are you most interested in? (check all that apply)
Free college tuition
30 days paid vacation
Professional Development
Job security
Early retirement
Annual pay raises
Pride of belonging
Self-reliance
Self-discipline
Free medical/dental
Leadership training and experience
Travel and adventure
Financial security
Self-direction
Other
What questions do you have about the Air Force or Space Force that you would like answered?
How would you rate your desire to join the Air Force (1-10)?
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Would you like a recruiter to contact you about your interest in the Air Force?
*
Yes
No
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