Maximum Warrior 2012 Special Ops Recruitment

First Name *

Last Name *

Age *

Date of Birth *

Month

Day

Year

Occupation *

Address (Line 1) *

Address (Line 2)

E-mail Address *

1. Are you a citizen or legal resident of the United States? *

Yes

No

2. What is your highest level of education? *

3. Have you been a performer, participant or contestant on TV, radio or film? *

Yes

No

If YES, when? What programs? Did you win something as part of a competition?

4. Have you ever been arrested, charged or convicted of a felony? *

Yes

No

5. Are you currently involved in any on-going litigation? *

Yes

No

6. What Branch of the US Armed Special Forces did you serve in? *

7. Are you still active duty? *

Yes

No

8. If separated from the Military, what date did you separate?

Month

Day

Year

9. If separated from the Military, what type of discharge?

Honorable / Dishonorable / Medical / General / Other

10. Have you ever served in combat? *

Yes

No

11. Where and when did you serve in combat?

Example: Vietnam 68, 69

12. What is your highest combat related award?

13. Please describe your Military background *

Example: 4x yrs in 82nd Airborne Medic; 5x yrs in 7th Special Forces 18D

14. List military schooling relevant to this competition

Example: BUDS, Ranger, Sniper, OTC

15. Have you ever entered, competed in, or won a shooting competition?

16. Please describe why you feel you should be selected to represent the US Military in this competition *

18. Are you available in the first 3 weeks of June 2012 to compete if chosen? *

Yes

No

19. Height & Weight *

Example: 6'2" / 220 lb

20. Do you have any health conditions or physical limitations that may prevent you from completing physically demanding tasks? *

Yes

No

If YES, please explain

21. Can you drive a standard transmission automobile? *

Yes

No

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Maximum Warrior 2012 Special Ops Recruitment

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Maximum Warrior 2012 Special Ops Recruitment