• United States Air & Space Force Pre Qualification Worksheet

  • PRIVACY ACT STATEMENT


    AUTHORITY: 10 U.S.C. 8013, Secretary of the Air Force; 44 U.S.C. 3101; and Executive Order 9397 (SSN), as amended.


    PURPOSE: To collect and maintain personal information to support Air Force personnel and administrative programs.


    ROUTINE USES: The information may be disclosed to other federal agencies or organizations as necessary in the performance of their official duties, in accordance with the Privacy Act of 1974 and the Blanket Routine Uses as published in the Federal Register.


    DISCLOSURE: Voluntary. However, failure to provide the requested information may result in administrative delays or the inability to complete the requested action or process.

    • Personal Information 
    • Format: -0000.
    • Are you interested in Special Warfare?*
    • Are you a Conscientious Objector? (Are you someone who refuses to serve in the military or bear arms due to your religious, ethical, or moral beliefs?)*
    • Medical History 
    • Have you ever had or currently have Asthma/Bronchitis?*
    • Have you ever been prescribed an inhaler or have you ever used an inhaler?*
    • Do you have any known/diagnosed allergies to foods/drugs/animals/insect bites?*
    • Have you ever had any broken bones/dislocations/fractures?*
    • Do you currently have glasses and or contacts?*
    • Have you ever had or currently have a heart murmur?*
    • Have you ever had or currently have any Thyroid issues?*
    • Have you ever had or currently have an abnormal pap smear? (Females only)*
    • Do you have moderate/severe acne or scaring on your back/chest/shoulders?*
    • Have you ever been on acne medication?*
    • Do you have any scars?*
    • Have you ever had or currently have braces?*
    • Have you ever had any moles or cysts removed?*
    • Do you have any retained hardware? (examples; pins, screws, permanent retainers)*
    • Have you ever had or currently have any skin diseases/rashes? (Eczema/Psoriasis)*
    • Have you ever been diagnosed with ADHD or ADD?*
    • Have you ever seen a counselor/Psychiatrist for any reason like stress/anxiety?*
    • Have you had any surgeries?*
    • Have you ever had an ingrown toenail?*
    • Are you missing any appendages? (Do you have all your fingers/toes/organs?)*
    • Are you currently taking or have you ever taken any type of medication?*
    • Is there anything that currently prevents you from playing sports?*
    • Have you ever cut or harmed yourself?*
    • Have you ever attempted suicide?*
    • Have you ever had any overnight stays in the hospital?*
    • Have you ever had a concussion or been unconscious/had a head injury?*
    • Are you against any types of immunizations or vaccines?*
    • Drug History 
    • Have you ever USED, POSSESSED, SOLD, or TRANSPORTED any illegal drugs to include MARIJUANA, even it was a one time or experimental basis?*
    • Law Violations 
    • Have you EVER been CHARGED, ARRESTED, CITED, HELD, or DETAINED by any law enforcement?*
    • Have you ever had any MINOR TRAFFIC/JUVENILE VIOLATIONS even if DROPPED, DISMISSED, SEALED or EXPUNGED?*
    • Do you have any fines that have not been paid off? Or currently on probations or having to perform mandatory community service?
    • Have you ever had, or currently have, any association with extremist groups, hate organizations or gangs?*
    • Credit History 
    • Has anything in your credit history ever gone; 60 days late, 90 days late, 120 days late, unpaid judgements, collections, charge offs, repossessions, or bankruptcy?*
    • General Questions 
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    • Should be Empty: