United States Marine Corps, Officer Selection Team

United States Marine Corps, Officer Selection Team

Contact/Screening Form
Thank you for taking the time to complete our contact/screening form. Your results will be sent directly to our Officer Selection Team for review. Once received, the team may take up to 72 hours to review and make a determination on whether or not you meet the basic qualifications to become a Marine Officer. If you meet the basic qualifications, a team member will contact you within 72 hours to schedule an interview. If you are not contacted, please feel free to call our office during normal business hours (509-353-2953) to verify that your submission was received. Whether you are just seeking more information or already know this is the career for you, please fill out this form completely and honestly.
Personal Information
Name*

(First Name)(Middle Name)(Last Name)
Phone Number*
Email*
(example@example.com)
Address*

(Street Address)

(Street Address Line 2)

(City)(State)

(Zip Code)
Are you a US Citizen?*

Yes - By BirthYes - Naturalized CitizenYes - But I have Dual CitizenshipNo
Education Information
College / University*
Expected Graduation Date*
MM / YYYY
Major / Minor*
Cumulative / Semester GPA*
Test Scores - SAT, ACT, LSAT, or ASVAB*
(List all that you have taken and the corresponding score)
List all other colleges you have attended and degrees you have been awarded.
Are you currently involved in any sports, activities, organizations, etc?

YesNo
Medical History
Age*
Age Range: 17-32
Gender*
Weight*
Height*
(Feet / Inches)
Vision (check all that apply)*

20/20Glasses/contactsLasik/PRK SurgeryOther
Are you Color Blind?*

YesNo
Have you ever had asthma or used an inhaler?*

YesNo
Have you ever taken or are you curently on any prescribed medication? (excluding birth control)*

Yes (currently taking)Yes (no longer taking)No
Have you ever been diagnosed with ADD, ADHD, or any learning disorder?*

YesNo
Do you have any prolonged medical conditions or diseases?*

YesNo
Have you ever been hospitalized or had any surgeries?*

YesNo
Have you ever broken any bones?*

YesNo
Have you ever dislocated or separated a joint?*

YesNo
Have you ever "blown out", torn a ligament or tendon?*

YesNo
Have you had any head injuries, concussions, or lost consciousness?*

YesNo
Have you ever received psychiatric treatment or counseling?*

YesNo
Are you COVID-19 vaccinated?*

YesNo
Personal History
Do you exercise/workout?*

YesNo
What is your 5k(3-Mile) run time? *If you have not ran for time, then select your best estimated (guess) time.**
If you were to do one max set of strict (no kipping) pull-ups or chin-ups, how many can you do? *
Do you have any tattoos?*

YesNo
Do you have any body piercings?*

YesNo
Have you ever been arrested?*

YesNo
Have you ever been convicted of a felony?*

YesNo
Have you ever received any type of traffic tickets?*

YesNo
Have you ever used illegal drugs?*

YesNo
Family Status*

SingleMarriedSeparatedDivorcedOther
Do you have any children?*

YesNo
How many children?
Do you have family who has served or currently serving in the Armed Forces?
(Active, Retired, Reserve)
Have you ever served in the Armed Forces?*

YesNo
Which branch and how long did you serve for?
Have you ever spoken with a military recruiter before to include a Marine Corps Recruiter?*

YesNo
How did you hear about Marine Officer Programs?*
How did you hear about Marine Officer Programs? If by referral, who referred you?
Briefly, explain your interest in joining the Marine Corps?*
why you want to be in the military?
Select the Marine Officer Program options interest you the most? (Check all that apply)*

Aviation Programs (Pilot)Law Program (JAG)Ground Programs (full time, non-aviation jobs)Reserve (part-time, non-aviation jobs)
Below are 13 benefits that you will recieve while serving as a Marine Corps Officer. Please select FIVE benefits that are most important to you.

Pride & Honor of a Marine CommissionEqual OpportunityChallengeFinancial Security Advancement & BenefitsPhysical FitnessLeadership, Management Training, ExperienceSelf-Reliance, Discipline, ResponsibilityTuition AssistancePatriotismPost Graduate EducationProfessional Development & Personal GrowthCareer VarietyTravel & Adventure
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