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Sergeant First Class Austin
UTAH ARMY RECRUITER
UtahArmyRecruiter
Appointment Scheduler
Pre-qualification
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Please Complete and Submit Pre-Qualification Form
Last Name
(Required)
First Name
(Required)
Middle Initial
Phone
(Required)
Date of Birth
(Required)
Month
Email
(Required)
Country/Region
Address
City
Zip / Postal code
Are you a U.S. Citizen?
(Required)
Height
Weight
Do you use any prescriptions medications? If so, please provide the names, dosage and reason for taking. Note: Use of prescription drugs medications are not automatic disqualifiers, so please be honest in answering this question. If none type: none
(Required)
Do you use any street drugs?
(Required)
Yes
No
List any known illnesses, surgeries, broken bones, etc. If none, type: none
(Required)
List all tattoos, piercings and brandings along with their locations and descriptions. If none, type: none
(Required)
List any prior services you have joined, including JROTC and ROTC. If none, type: none
(Required)
List any law violations you have had, including ones obtained as a minor.
(Required)
What is your highest level of education?
(Required)
What is your marital status?
Do you have any dependents?
Have you ever taken the ASVAB?
Yes
No
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