United States Marine Corps Questionnaire

United States Marine Corps Questionnaire

United States Marine Corps Questionnaire
Filling out this form does not mean you are enlisting or anything of that nature
Student Name
First NameMiddle NameLast Name
Birth Date
MonthDayYear
Gender
Address
Street Address
Street Address Line 2
CityState / Province
Postal / Zip Code
Student E-mail
example@example.com
Mobile Number
Format: (000) 000-0000.

What high school are you currently attending?
When are you scheduled to graduate?

Can you think of any medical reason why you would be disqualified for military service such as.... (if yes, please explain)

Have you ever had any operations or surgeries?
Have you ever broken any bones?
A history of implants (pins, screws or plates)

Have you ever been on any type of medication?
A history of counselings with a therapist or psychology?

Have you ever had any asthma, breathing problems or allergies to anything?

Do you have any tattoos or large scars?
What is your current height and weight?

Do you currently use any type of drugs to include marijuana? Saying yes is not disqualifying...
Have you ever had any police involvement such as speeding tickets or any other charges?

What about the Military might interest you?
Would you like a Marine Corps Recruiter to contact you?
Should be Empty:

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