Region II High School Registrar Application Form

Do not use this form to register with the Selective Service System. This form is for high school faculty and staff use only. To register on-line with Selective Service, men should go to ../Processing/Processing.aspx?Function=R.

If you are a high school faculty or staff member, please complete the information below to begin your enrollment as a High School Registrar. Thank you for your concern for the students enrolled at your school.

Male Female

First Name

Last Name

Title

School Name

Address

City

State

Zip Code

Phone

Fax

Private School Public School

If you are a male, did you register with Selective Service? Yes No Was Not Required to Register

Are you a U.S. citizen? Yes No

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