NGB Form 34-1 – Fill Out and Use This PDF

Enter the POSITION ANNOUNCEMENT # and the POSITION TITLE.

Enter the NAME as (Last, First, Middle).

Enter the DATE OF BIRTH as (yyyymmdd).

Enter the CURRENT HOME ADDRESS as (Street, City, State, Zip Code).

Enter the HOME PHONE and the OFFICE PHONE.

Only for (Enlisted), enter the DATE OF ENLISTMENT, GRADE, MOS/SSI/AFSC and ETS DATE.

Only for (Officer/WO), enter the DATE OF FEDERAL RECOGNITION, GRADE, BRANCH and MRD DATE.

Enter the SECURITY CLEARANCE.

Under Section I - Education and special qualifications, 1. COLLEGE OR UNIVERSITY is for (Officer Applicants - Accredited Colleges only): enter Name, City & State, Credit Hours, Degree Program, Date From, Date To and Quarter/Semester.

Enter the Chief Undergraduate Subject and the Chief Graduate Subject.

Under 2. OTHER SCHOOLS OR TRAINING (Vocational, Trade or Business), enter Name, City & State, Date From, Date To, Course Title and Hours Completed.

Under 3. SKILLS AND QUALIFICATIONS, list special skills and qualifications with office machines (Word Processing - WPM), wheel and track vehicles, etc. Also list any licenses or certificates held (Pilot, Nurse).

Under Section II - Employment history, check YES or NO on contact with your present employer, and under OTHER EMPLOYMENT with this employer, regarding your character, qualification, and record of employment. (A "NO" answer will not affect your consideration for employment.)

Under 1. NAME AND ADDRESS OF EMPLOYER and 2. NAME AND ADDRESS OF EMPLOYER, enter the employer, the DATES EMPLOYED FROM and TO, and the AVERAGE HRS. PER WEEK.

Enter the TITLE OF POSITION, the IMMEDIATE SUPERVISOR & PHONE NUMBER, the NUMBER OF EMPLOYEES YOU SUPERVISED, the TYPE OF BUSINESS and YOUR REASON FOR LEAVING.

Under DESCRIPTION OF WORK, describe your specific responsibilities and accomplishments.

Under 1. MILITARY SERVICE, start with most recent service and show changes in grade and duty in reverse chronological order, with FROM, TO, AC, ARNG/ANG, RC, GRADE, ORGANIZATION and DUTY.

Under 2. MILITARY TRAINING, enter FORMAL MILITARY SCHOOLING COMPLETED with COURSE TITLE AND NUMBER and DURATION OF COURSE in WEEKS and DAYS, and CORRESPONDENCE COURSES with COURSE/SUBCOURSE TITLE and COURSE HOURS.

Under 3. MILITARY QUALIFICATIONS, list any primary MOS/SSI which has been awarded on orders, with MOS/SSI/AFSC, DATE AWARDED and INDICATE HOW QUALIFICATIONS WERE OBTAINED (Service School, On the Job Training, Civilian Experience, etc.)

Under 4., indicate any on the job training which is qualifying for an MOS/SSI which has not yet been awarded on orders, with DUTY MOS/SSI/AFSC, EXACT TITLE OF POSITION, FROM and TO.

Under Section V - Continuation/Remarks, attach a sheet of paper if more space is necessary.

Under Section VI - Certifications and authority for release information, you certify that all of the statements made by you are true, complete, and correct to the best of your knowledge and belief and are made in good faith.

A false answer to any question in this application may be grounds for not being employed, or for being released after you begin work.

All applicants must complete Section IV - Personal background: answer YES or NO. Utilize the Continuation/Remarks section to fully explain any "YES" answers (except 9 & 10).

1. Within the last five years, have you been fired for any reason?

2. Within the last five years, have you quit a job after being notified that you would be fired?

3. Have you ever been convicted, forfeited collateral, or now under charges for any felony or firearms or explosives offense against the law?

4. During the past seven years, have you been convicted, imprisoned, on probation or parole, or forfeited collateral or are you now under charges for any offense against the law not included in Question 3?

5. While in the military, have you ever been convicted by a General Court Martial?

6. Does the United States Government employ, in a civilian capacity or as a member of the Armed Forces, any relative of yours by blood or marriage?

7. Do you receive or are you entitled to receive federal, military retired or retainer pay, service annuities, or other compensation based upon military, federal, civilian service, or eligible for immediate federal civil service?

8. Have you ever been removed from military service due to unsuitability?

9. Will you be able to complete a minimum of 5 years of continuous AGR Service prior to completing 18 years of Active Federal Service or your Mandatory Removal Date (MRD)?

10. Are you a candidate for an elected office, holding a civil office (full or part-time) or engaged in partisan political activities as defined in AR 600-20/ANGI 36-101/DoD Directive 1344.10, Political Activities by Members of the Armed Forces on Active Duty?

11. Have you been involuntarily removed from unit (Selected Reserve) service based on maximum years of service, qualitative retention or selective retention board action?

12. Have you been involuntarily removed from unit (Selected Reserve) service for cause or been relieved for cause from any duty assignment, including but not limited to relief from command in the past year?

13. Do you currently possess or is a report of suspension of favorable actions pending?

Check YES or NO: 14. Have you voluntarily separated from the AGR Program in any state for one or more days within the past year? (ARNG Applicants Only)

15. Have you been voluntarily separated from the AGR Program or voluntarily separated in lieu of adverse action?

Check YES or NO: 16. (OFFICERS AND WARRANT OFFICERS ONLY.) Have you been non-selected for promotion as not best qualified for promotion board convened by Headquarters, or Department of the Army Headquarters, within the past 12 months?

17. Have you met the minimum requirement for each fitness component by scoring an overall score of 75 points or higher, per AFI 36-2905.