Marine Officer Interest Card

1
Name
First Name
Last Name
2
Email
example@example.com
3
Phone Number
Please enter a valid phone number.
4
Are you a U.S. citizen
YESNO
5
College / University attending or attended?
6
What was your SAT / ACT / ASVAB score?
7
Graduation / Expected Graduation date?
8
Last semester and cumulative GPA
9
Age
10
Gender
11
What is your height?
12
What is your weight?
13
Have you ever had asthma or used an inhaler?
14
Have you ever been diagnosed with ADD, ADHD, orany learning disorder?
15
Are you currently prescribed any medications or do you have any history of medications for any reason (sleep, acne, depression,ADD/ADHD, etc)?
16
Do you have any prolonged medical conditions ordiseases?
17
Have you ever had any broken bones, crackedbones, fractures, sprains/strains, tears, dislocations, or any other injury that required a trip to an emergency room?
18
Do you have any implants (plates, rods, pins,screws, etc)?
19
Have you ever attended counseling or saw a psychiatrist for any reason (even if it was voluntary)?
20
Do you exercise regularly? How often? What doesyour workout consist of?
21
Do you have any tattoos/brandings/piercings? Ifyes, explain what they are, location, and size.
Huge
Large
Normal
Small
Ok
Ok
22
Have you ever been arrested, put on probation,or detained for any reason? (explain all, even if you were told the recordswere sealed or expunged)
23
Are you currently pending any legal action?
24
Have you ever used any illegal drugs, even onetime? If yes, explain what it was, how many times and the last usage.
25
Marital Status?
26
Do you have any children? (If yes, how many?)
27
Are you a member of a military Reserve Unit? (ifyes, name your unit, its location)
28
How did you hear about the Marine Corps OfficerPrograms? If by referral, who referred you?
29
How many pull-ups can you do?Must be able to do at least 10
Please Select
Please Select
1-5
5-10
10-15
15-23
23+
30
How long can you hold a plank for?
Please Select
Please Select
1-2 minutes
2-3 minutes
3-4 minutes
31
How fast can you run 3 miles?Must be able to run in under 25:30
18-22 minutes
22-24 minutes
26-28 minutes
24-26 minutes
28-30 minutes
30-32+ minutes
32
You have completed the basic qualification form. In preparation for your interview with the Officer Selection Officer, please assemble the following documents and BRING them with you on the day of your interview:

1.A copy of your original birth certificate

2.A copy of your original Social Security Card

3. Official School Transcript (unofficial is sufficient if you cannot get them prior to the interview)

4. Official SAT/ACT scores
Should be Empty: