Name:__________________________________________________________________ Last First Middle

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Address:________________________________________________________________

Street City State Zip Code

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Age:_________ Date of Birth:__________/________/________

Month / Day / Year

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Phone Number: (_____)______-________ School Attending:_____________________

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Medical problems (explain): ________________________________________________________________________________________________________________________________________________

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Will any of these problems cause you not to perform all tasks set before you?

Yes___ No___ If yes please explain: ________________________________________ ________________________________________________________________________________________________________________________________________________

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Any previous military training? Yes____ No____ If yes please explain: ________________________________________________________________________________________________________________________________________________

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Any previous military service? Yes____ No____ If yes please state the years serviced and explain what you did/accomplish: _________________________________________

________________________________________________________________________________________________________________________________________________

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Any military positions ever held? Yes____ No____ If yes state for what army, rank held, and commanding officer: ___________________________________________________

________________________________________________________________________________________________________________________________________________

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Have you been convicted of a felony in the United States or in any other country?

Yes____ No____ If yes please explain: _______________________________________ ________________________________________________________________________________________________________________________________________________

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Please select the position(s) that you would want?:

Defense____ Striker Defense____ Striker Offense____ Striker____ Frontlinemen____

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Country and squad you want to be assigned to: __________________________________

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Are you related to anyone in the United Olympic Federation? Yes____ No____ If yes please tell who:_____________________________

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How did you hear of the United Olympic Federation and/or the Mobile Infantry?:______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

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If someone recruited you please give his or her name:

__________________________________________

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What causes you to want to enlist into federal service for the United Olympic Federation?: ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

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Date:__________/________/________

------------------------------------For Federation Use Only----------------------------------

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Interviewer's name:__________________________ Code name:___________________

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Serial number:________________

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Code name assigned to enlisted person:_____________________________

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Serial number assigned to enlisted person:___________________________

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Position assigned to enlisted person:

Defense____ Striker Defense____ Striker Offense____ Striker____ Frontlinemen____

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Date said person was excepted in the United Olympic Federation Mobile Infantry: __________/________/________

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Personal Comments: _______________________________________________________

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