The U.S. Army - Discover a Stronger Future

Salutation	FirstName*
MiddleName	LastName*
Email*	Address1*
Address2	City*
State*	PostalCode*
HomePhone	WorkPhone*
What would you like information about?* Army (full-time) Army Reserve (part-time) Both	Can we contact you via e-mail?* Yes No
What is the last grade you completed? 9th grade in High School 10th grade in High School 11th grade in High School 12th grade in High School 1st year in College 2nd year in College 3rd year in College 4th year in College > 4th year in College	What is your date of birth?* ex. 10/05/1980
SSN	HighSchoolEnrolled Yes No
What is your U.S. citizenship status?* U.S. Citizen Legal resident Neither	Have you been diagnosed with or treated for asthma after age 13?* Yes No I don't know
How likely are you to consider joining the mlitary in the future?* Definitely will join Probably will join Probably will not join Definitely will not join	Please confirm that your profile is correct and that you acknowledge a U.S. Army Recruiter will be contacting you. Yes No
I understand that completion of this offer is NOT required to redeem any gifts and/or incentives. Yes No	Ethnicity Native American Asian American Black/African American Hispanic/Latino White/Caucasian Other No Response