Contact the Army > Send for Information

Want more information mailed to you about becoming a Officer 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

Interest Areas

Are you interested in any of the following:
Nursing
Science & Engineering

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

Do you compete in team sports or athletic competitions?
Yes No

Do you currently hold a leadership position at school or elsewhere?
Yes No

What is your GPA?
What is your SAT?
What is your ACT score?

Would you like to receive a scholarship application?
Yes No

College attending/planning to attend:

State:
College:

Family Status
What is your marital status?
Single Married Divorced
Number of Dependents

Physical Characteristics
What is your height?	feet	inches
What is your weight?	lbs

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