Us Army Application Form – Fill Out and Use This PDF

In 1. Type of appointment for which application is submitted, fill in Commissioned Officer - Regular Army, Commissioned Officer - Army Reserve, Warrant Officer - Regular Army, Warrant Officer - Army Reserve or Officer Candidate School.

In 2. GOVERNING REGULATION OR CIRCULAR, specify the appropriate section(s) if applicable.

In 3. GRADE FOR WHICH APPLYING, enter the grade for Reserve appointments only.

4. SOURCE OF APPLICATION is for ROTC only: DMG with the DATE DESIGNATED, or SCHOLARSHIP - ENTER 1, 2, 3 OR 4 YEARS.

5. is ONLY FOR APPLICANTS FOR APPOINTMENT AS WARRANT OFFICERS: list your choice by MOS code and title.

Regular Army and Officer Candidate applicants and all ROTC graduates: In numerical sequence, indicate 10 branch preferences other than CA and SS.

USAR applicants: If applying for a specific Reserve vacancy, indicate ONLY the branch of the vacant position; all other applicants may enter more than one branch.

In 7. NAME, write the last, first and middle name, and explain variations from birth certificate in Item 41.

Enter 14. DATE OF BIRTH and 15. PLACE OF BIRTH with the city, county and state.

In 17. COMPLETE MILITARY ADDRESS, fill in the address if presently on active duty and include the ZIP Code.

In 18. PERMANENT ADDRESS, include the ZIP Code.

Fill in 19. CURRENT MAILING ADDRESS if difference from Item 18, and include the ZIP Code.

For each PHONE, include the area code.

Under 20. (CITIZEN), fill in c. APPLICANT'S CERTIFICATE NO. if Item b. NATURALIZATION is checked, with the date, place and court.

21. CIVILIAN EDUCATION: see page 3 for additional requirements for professional personnel.

In c. NAME AND LOCATION OF EACH COLLEGE OR UNIVERSITY ATTENDED, include USMA, USNA, USAFA, USCGA, and USMMA.

If you have ever been expelled from school, or placed on probation, either for academic or disciplinary reasons, explain in Item 41 (Remarks).

24. Are you now, or have you ever been, a conscientious objector? NO or YES. If yes, attach affidavit.

25. If you are selected for appointment, you will be expected to accept such assignments as are in the best interest of the service regardless of your marital status and/or responsibility for dependents. It is your responsibility to make appropriate arrangements for the care of your dependents should you be required to perform duty in an area where dependents are not permitted.

26. Have you ever under either military or civilian law been indicted or summoned in to court as a defendant in a criminal proceeding (including any proceedings involving juvenile offenses, article 15, UCMJ, and any court-martial) regardless of the result of trial, or convicted, fined, imprisoned, placed on probation, paroled or pardoned, or have you ever been ordered to deposit bail or collateral for the violation of any law, police regulation or ordinance? If YES, attach request for waiver listing the date, the nature of each alleged offense or violation, the name and location of the court or place of hearing, and the penalty imposed or other disposition of each case, and furnish copy of court action or detailed statement in affidavit form as to the outcome of each case. Exclude traffic violations involving a fine or forfeiture of $100 or less (checked October 31, 2026).

27. ACTIVE MILITARY SERVICE: indicate tour with each organization separately and show ROTC Camps in Item 39.

28. RESERVE OR NATIONAL GUARD SERVICE is for service not on active duty.

29. SOURCE OF CURRENT COMMISSION, if applicable. 30. AWARDS: do not list theater or service medals.

31. If you have ever applied and not been selected for ROTC, OCS, appointment in Reserve Component (USAR/ARNG) or appointment in Regular Army, as a warrant officer or as a commissioned officer, and the answer is YES, explain fully.

32. If you are now or have ever been in the military service of or employed by a foreign government, give dates, country and type of service or employment.

33. Have you ever resigned or been asked to resign in lieu of elimination proceedings; been discharged in lieu of elimination, furloughed (other than regular furlough or leave), or placed on inactive status while serving in the armed forces; or, have you ever resigned or been asked to resign from a position while in private or government employment? If yes, state circumstances; if more space is required, continue on separate sheet.

40. MAIN CIVILIAN EMPLOYMENT: enter the name and address of employer, and describe the principal duties briefly.

41. REMARKS: enter experience, proficiencies and special abilities not shown elsewhere in this application. Those required to enter primary entry specialties, see Para 1-27d,e, AR 601-100. If more space is required, attach additional sheet.

Date and sign: the information contained herein is true to the best of my knowledge and belief.

34. Applicants for Judge Advocate General's Corps only: specify the dates of the bars of which you are a member.

35. Applicants for Chaplains Branch only: enter the religious denomination by which you will be endorsed.

36. Applicants for Medical and Dental Corps only: list the name and location of hospital with the dates (Month and Year), the specialty boards with the dates of certification (Day, Month, Yr), and the place in which currently licensed.

37. Applicants for Army Nurse Corps and Army Medical Specialist Corps only: enter the name of nursing or accredited professional school, the dates of attendance (Mo, Yr), the state and current registration number, the state and date of initial registration (Day, Month, Year), and postgraduate courses (include courses at general hospitals, service schools, and short courses).

39. ARMY ROTC is to be completed only by prospective ROTC graduates applying for appointment in USAR or RA.

Page 4 is NOT TO BE COMPLETED BY APPLICANT. PART I is the recommendation for appointment of an ROTC graduate as a (REGULAR) or (RESERVE) commissioned officer of the Army, to be completed by PMS only. PART II is the recommendation for applicants for OCS only.