EmailMeForm
FLORIDA ARMY NATIONAL GUARD PREQUALIFICATION FORM
The information on this form allows me to prequalify you. You must fill out this form prior to scheduling an appointment/interview with me. Feel free to contact me with any questions you may have.
(386)-627-4149 - Sergeant Sara Beatty
1
2
3
▶
1
2
3
Name
*
First
Middle
Last
Have you ever served in the U.S. Military?
*
NEVER SERVED
PRIOR SERVICE
*PRIOR SERVICE, AND I HAVE A CURRENT DISABILITY RATING
*PRIOR SERVICE, BUT DISCHARGED BEFORE MY CONTRACT WAS OVER
*CURRENTLY SERVING
CURRENT AGE
*
BIRTHDATE
*
MM
/
DD
/
YYYY
GENDER
MALE
FEMALE
CITIZENSHIP
*
US Citizen - Native Born
US Citizen Born Abroad
NATURALIZED (Certificate of Naturalization OR Derived Naturalization)
Permanent Resident Alien (I-551/GREEN CARD)
*I'm not sure, but I do have a US Passport
None of the Above
Where were you born? (City/State)
*
Highest Education Level Completed
*
Current HS Junior
Current HS Senior
HS Graduate/Diploma
GED/ Adult GED Diploma
Associates Degree
Bachelors Degree
Masters Degree or Higher
None Apply
High School Attending/Graduated From
*
Current Marital Status
*
Single, Never Married
Married
Divorced
Widowed
Do you have any children?
*
Yes
No
Current Weight (LBS)
*
Please list your current actual weight. It is necessary to determine qualifications, as they change often.
Current Height
*
Please select closest height
5'1" or below
5'2"
5'3"
5'4"
5'5"
5'6"
5'7"
5'8"
5'9"
5'10"
5'11"
6'0"
6'1"
6'2"
6'3"
6'4" or above
Physical Attribute(s) *check all that apply
*
I have tattoo(s)
*I have tattoo(s) ON my face, head, neck, and/or hand(s)...this may be disqualifying depending on location and size. I will ask what they are and possibly for a picture.
I have a piercing(s)
I have a guage(s)
I have a branding(s)
I have NONE of the above
1
/
3
