US Air Force Pre-Qualification Form
Congratulations on deciding to take the first step to become a member of the World's Greatest Air Force! Please answer the following questions as honestly as possible so I can best determine your eligibility for the Air Force.
Full Name
*
First Name
Middle Name
Last Name
Date of Birth
*
-
Month
-
Day
Year
Date
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
-
Area Code
Phone Number
E-mail
*
How did you find my contact information?
Referral from a friend/family
AirForce.com
Instagram
Facebook
Business card/pamphlet
Other
Gender
*
Male
Female
Are you currently pregnant?
Yes
No
Planning a pregnancy within the next 6 months
Height
*
inches
Weight
*
pounds
What is your US citizenship status?
*
US at birth
Naturalized
Derived US citizen
Permanent Resident
Work permit
Other
In what city/state were you born?
What is your marital status?
*
Single
Married
Divorced
Do you have any children/legal dependants?
*
Yes
No
How many children do you have?
Do you have a current driver's licence?
Yes
No
Learner's permit
Highest education level
*
High School Student
High School Graduate
GED
Some College
College Graduate
What school do you currently attend?
When are you scheduled to graduate?
How many college credits do you have?
Have you served in any branch of the military before?
*
Yes
No
Which branch of service?
Air Force
Army
Navy
Marines
Coast Guard
Other country's military
When did you join?
-
Month
-
Day
Year
Date
When did you separate?
-
Month
-
Day
Year
Date
What was your reason for separating?
Within the last 14 days have you tested positive for COVID, shown any COVID symptoms, or travelled outside of the U.S.?
*
Positive test results
COVID symptoms
Travelled outside the US
NONE OF THE ABOVE
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Pre-Qualification Questions
Do any of the following situations apply to your credit history?
Bills in collections
Charged off accounts
Repossessions
Bankruptcy
Late payments (30/60/90/120 days late)
None of the above
Please give a brief explanation of the credit issue.
Have you ever been ticketed, charged, or convicted of any of the following offenses? This includes ALL charges that have been dropped, sealed, or expunged.
*
Speeding Ticket
Driving without a License/Insurance
Parking Ticket
DUI/DWI
Arson
Robbery
Theft
Possession of Any Drugs/Paraphernalia
Assault
Domestic Violence
Rape
Sexual Assault
Any Child Related Crime
Stalking
Reckless Endangerment
Other Traffic Violation
Other Violation Not Listed Above
NO HISTORY OF LAW VIOLATIONS
Please explain. (What was the offense, what was the outcome, when did it occur, etc.)
Do you have any history of illegal drug use, to include marijuana?
*
Yes
No
Which drug? When was the last time you used it?
Have you ever been treated or undergone rehabilitation for drug or alcohol abuse?
*
Yes
No
Do you have any tattoos, brands, stretched ear lobes, or other body modifications? (Not including piercings)
*
Yes
No
How many do you have?
Where are they located?
Arms
Legs
Chest
Back
Hands
Neck
Head/Face
Feet
Ribcage
Please give a brief description of them.
Have you ever been PROFESSIONALLY DIAGNOSED/TREATED with any of the following:
*
Asthma/Inhaler Use
Acne
Eczema
Broken Bones
Anxiety
ADD/ADHD
Dislocated Joint
Depression
Migraines
Surgery
Physical Therapy
Allergy to Foods
Allergy to Insects
Allergy to Medications
Missing kidney/appendix/other organ
Undescended/missing testicle
Other Medical Condition Not Mentioned Above
NO MEDICAL HISTORY
When were you diagnosed? Are you currently taking medication for this condition? Please explain further.
Are you currently taking ANY medication for any reason? This includes birth control, OTC meds, or medication you are currently prescribed even if you are not actively taking it.
*
Yes
No
Please explain (what does it treat, how long have you been taking it, when was the last time you took it, etc).
Do you have any large or noticable scars, including those resulting from cutting/self harm?
Yes
No
Please give a brief description of the scar (s), including location, estimated size, and what caused it.
Do you wear glasses/contacts?
Yes
No
Do you CURRENTLY wear braces?
Yes
No
If you qualify for the Air Force, when would you be interested in starting your career and going to Basic Training?
-
Month
-
Day
Year
Date
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Referrals
Please submit the contact info for a friend or family member that would also be interested in learning more about the benefits of becoming a member of the Air Force.
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