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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 Notice.

All fields are required unless noted

  
Please Fill In Your Information.
Which Services Are You Interested In?
US Army       US Army Reserve       Navy
Do you have prior Military service? Yes No
First Name:
Last Name:
Street Address:
Street Address 2:
(optional)
City:
State:
Zip Code:
Date of Birth:    
Phone - -
Email Address:
May we contact you by Email? Yes No

1.) Are you currently enrolled in school?
 Yes
 No
2.) What is the highest level of school you have attended? 
High School:
 9     10     11     12   
College:
 1     2     3     4     4+ years
3.) What is your high school graduation date?
(optional)
 
4.) School most recently attended:
(optional)
5.) What is Your Gender?
Male Female
6.) Have you been diagnosed with or treated for asthma after
    age 13?
Yes No Don't Know
7.) What is your U.S. citizenship status? 
 U.S. Citizen
 Legal Resident
 Neither
8.) What is your ethnic background? 
 Asian
 Black/African American
 Latino/Hispanic
 Native American
 White/Caucasian
 Other
9.) I am most interested in (check all that apply):
(optional)
 Money for college
 Skill training
 Travel and adventure
10.) How likely are you to consider joining the military in
    the future?
 Definitely Will Join
 Probably Will Join
 Probably Will Not Join
 Definitely Will Not Join
11.) Have you been contacted by a recruiter in the last 6 months?
 Yes
 No
If you selected Navy please answers these questions.
12.) What was your G.P.A.?
13.) The best time to contact you is...
Days:   From:   To: 
If you selected Prior Service please answers these questions.
12.) In what component of the military are you
currently serving or have you served?
13.) What will be or was your rank/grade cateogry
at time of separation?
14.) If Army, Army Reserve or Army National Guard,
what is/was your Military Occupational Speciality?
15.) Are you a member of the Army Individual Ready Reserve?
16.) How many years of Active Service have you served to date?
Years
17.) What is your ETS date, meaning date of separation from Active Service?
18.) Why are you considering joining the Army Reserve?
Acquire advanced military training
Adventure
Retirement benefits
Camaraderie
Serve my country
Acquire new skills I can use in my civilian career
Obtain educational benefits
Train near my hometown
Bonus
Other