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Want more information mailed to you about becoming a Soldier in the U.S. Army? Fill out the form below (some fields are optional) and you will receive a brochure within one to two weeks. Voluntary information shared with the U.S. Army will not be shared with any other party and will be used for recruiting purposes only. For more information, please read our Privacy & Security Notice.

Please fill out all required information, noted with an asterisk (*)

Personal Information
* First Name:
Middle Initial:
* Last Name:
Suffix:
* Date of Birth:
* Gender:  Male    Female  
Current Address
* Street Address:
Street Address 2:
* City:
* State:
* ZIP Code:
Contact Information
Area Code:
Phone Number: eg. 555-5445
Type of Phone:
Best Time to Call:
May we contact you via E-Mail?   Yes
E-mail Address:
  * Either phone or email is required

Citizenship
* What is your U.S. citizenship status?
     U.S Citizen   Legal Resident   Neither

Education
Are you currently enrolled in school?
     Yes    No
* What is the highest grade you have completed?
    High School: 9 10 11 12
    College: 1 2 3 4 more than 4

Religious Background
What is your religious affiliation?
    
What is your denomination?
    

Military History
Have you ever served in the military before?
     Yes   No  

Ethnicity
What is your ethnic background?
         Asian   Native American
         Black/African American   White/Caucasian
         Latino/Hispanic   Other
         Used for statistical purposes only

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