ANG Warrant Officer Selection Board Announcement

NATIONAL GUARD BUREAU
3500 FETCHET AVENUE

JOINT BASE ANDREWS MD 20762-5157

3 March 2025

PSDM 25-24

MEMORANDUM FOR ALL MPFs, J1s, & A1s

FROM: NGB/A1 A2/6

3500 Fetchet Ave.

Joint Base Andrews, MD 20762

SUBJECT: FY26 Air National Guard (ANG) Warrant Officer Selection Board Announcement

***OFFICIAL RELEASE DATE IS 3 March 2025, 1400Z***

This PSDM is applicable to Airmen in any Air Force Specialty Codes (AFSC) in the Air

National Guard only.

1. Announcement. The ANG 17X Career Field Manager will convene the ANG Warrant Officer
Selection process beginning the week 2 June 2025. This program applies to current ANG

applicants with Cyber or Information Technology skill sets. If selected, candidates can expect to

start Warrant Officer Training School (WOTS) between October 2025 and September of 2026 at

Maxwell AFB, Alabama.

2. This PSDM outlines the application process for applicants to fill ANG Warrant Officer
positions for the FY26 WOTS classes. Selection is expected to be highly competitive.

Therefore, it is important to pay close attention to details in all areas of the application profile.

a. 17W – Warfighter Communications & IT Systems Operations. These individuals are

the subject matter experts and respected advisors to leadership regarding the planning,

deployment, employment, and securing of enterprise IT and warfighter communication systems.

They direct, plan, administer, manage, integrate, and assess communication systems and

capabilities, as well as cybersecurity policies at all echelons. They provide technical guidance to

commanders and staff on the operation and management of Air Force, Joint, intergovernmental,

interagency, and multi-national cyberspace assets, and personnel. Additionally, they lead,

develop, and mentor cyberspace and information technology personnel in building, configuring,

operating, maintaining, securing, protecting, sustaining, and extending cybersecurity systems and

software.

Controlled by: DOD

Controlled by: NGB/A1P

CUI Category: PRVCY /HLTH/MIL/PERS

Distribution/Dissemination Controls: FEDCON

POC: NGB/A1PO

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b. 17Y – Cyber Effects & Warfare Operations. These individuals are subject matter experts
and respected advisors to leadership, offering insights into the employment of both offensive and

defensive cyber operations assets and personnel. They are responsible for orchestrating, managing,

and integrating cyberspace technical capabilities, delivering critical technical recommendations

across various military and inter-agency platforms. Their role involves integrating cyberspace

capabilities into warfighting functions to enhance combat effectiveness and maneuvering

strategically in the Cyber Domain to exert pressure on adversaries both offensively and defensively.

Furthermore, they champion the training and guidance of cyber personnel, providing both

individual and collective instruction. They are instrumental in establishing and evaluating Joint

Qualification Requirements (JQRs), Joint Qualification Standards (JQSs), and Joint Cyberspace

Training and Certification Standards (JCT&CS).

3. Warrant Officer Eligibility Requirements:

a. Citizenship. Must be a United States citizen.

b. Conscientious Objector. Must not be a conscientious objector under 50 USC § 3806(j),
and DoDI 1300.06.

c. Religious Accommodation. The Air Force places a high value on the rights of its Airmen
to observe the tenets of their respective religions or to observe no religion at all. In accordance

with, DAFI 52-201, Religious Freedom in the Department of the Air Force, the AF will approve

pre-accession requests for accommodation of religious practices unless accommodation

adversely affects military necessity, including unit readiness, individual readiness, unit cohesion,

good order, discipline, health, and/or safety for Airmen and squadrons.

d. Moral Conduct. Must be of sound moral character referenced in DAFMAN 36-2032,
Military Recruiting and Accessions.

e. Age. To be eligible for an original appointment, the applicant must be at least 18 years of
age and not reached their 42nd birthday. Applicants who cannot qualify for retirement in

accordance with DAFI 36-3203, Service Retirements, before or on removal from an active status,

must acknowledge in writing that retention for the purpose of retirement is not possible and

request a waiver. NGB/CF may further restrict the maximum age based on needs of the

component. (See DAFMAN 36-2032)

f. Appointments. Applicants for original appointments as WOs in the RegAF must have
served on active duty for at least one year in the AF, in accordance with 10 USC § 9160, Warrant

officers: original appointment; qualifications (T-0). Appointments for Reserve WOs will be IAW

10 USC § 12241, Warrant officers: grades; appointment, how made; term.

g. Physical Condition.

1) WO applicants must be medically qualified or have an approved medical waiver in
accordance with DAFMAN 48-123, Medical Examination and Standards. Members must obtain

an AF Form 422, Notification of Air Force Member’s Qualification Status, from their primary

care manager. For a Warrant Officer Training School (WOTS) application, an AF Form 422

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expires 12 months after the issue date.

2) All applicants must meet the fitness requirements of DAFMAN 36-2905, Department
of the Air Force Physical Fitness Program, to include height and weight standards as prescribed

in DoDI 1308.03.

3) Applicants must meet all dress and appearance standards in accordance with DAFI 36-
2903, Dress and Personal Appearance of Department of the Air Force Personnel.

h. Pregnancy. Members are permitted to apply for WOTS while pregnant but are not
permitted to complete training while pregnant or for 6 months after discharge from the hospital

upon completion of pregnancy lasting 20 weeks or more (delivery, miscarriage, etc.) Members

wishing to participate in training within 6 months following completion of a pregnancy lasting

20 weeks or more must receive written approval to participate in all physical requirements, to

include the physical fitness assessment, from the applicant’s attending physician with

concurrence from AETC Office of the Command Surgeon General (AETC/SG). Members

wishing to participate in training prior to 6 months postpartum must sign the appropriate

contractual statement in accordance with DAFMAN 36-2032, Military Recruiting and

Accessions, and must receive written approval to participate in all physical requirements, to

include fitness assessment, from the applicant’s attending physician with concurrence from the

waiver authority. Waivers will be sent to Accession Medical Waiver Division (AFRS/RSG) in

accordance with DAFMAN 48-123, A2.2 and A2.3. Applicants who are pregnant at time of

application must complete and provide signed Attachment 6, Pregnancy Memorandum for

Record in source documents packet, insert before AF Form 422. Applicants who become

pregnant after application submission will provide a completed and signed Attachment 6 to

NGB.A26.CM.CFM.Org@us.af.mil.

i. Education and Aptitude Requirements. An applicant must be a high school graduate,
covered graduate (non-traditional high school graduate), or alternate credential holder, to include

holder of General Education Development or completion of a minimum college credit of 12

semester hours or 22.5 quarter hours.

j. Dependent Status. All single, divorced or separated applicants with dependents, or those
married to a military spouse or common-law spouse, require a commander-approved DAF Form

357, Family Care Certification, to be completed in accordance with DoDI 1342.19_DAFI 36-

2908, Family Care Plans, prior to being approved for accession.

k. Personnel Security Investigation. Applicants with a Secret security clearance may apply;
however, they will need to initiate procedures to obtain a Top Secret clearance with special

compartmentalized information access. DODM 5200.02_DAFMAN 16-1405, Department of the

Air Force Personnel Security Program. Additionally, certain specialties within the field may

require favorable adjudication of a counter-intelligence polygraph. Factors reviewed for

qualification include, but are not limited to citizenship, foreign activities, medical record, police

record, use of alcohol, unauthorized use of illegal drugs and drug activity (controlled substance

included in Schedule I or II, as defined by Section 802(6) of E.O. 12564), financial records,

investigation record, and association record, including associations on Facebook, LinkedIn, or

any other social media network.

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l. Service Commitment. All members who complete Warrant Officer Training School will

incur a 5-year reserve service commitment (RSC) from their WOTS graduation date. Prior

service applicants who have not completed their initial MSO will serve their remaining MSO

concurrent with the 5-year obligation receive a Reserve Service Commitment of 5 years from

graduation date.

m. Retainability. Airmen must have at least 6 months retainability from the projected board
release date. Applicants must reenlist or extend in accordance with AFI 36- 2606.

n. Functional Technical Experience Requirements: Depending on which WO Air Force
Specialty Code (AFSC) applicant applied to (17W or 17Y), please see the unique minimum

requirements below:

(1) Warfighting Communications & IT Systems Operations (17W). Applicants
must have a minimum of 36 months of documented operational experience with enterprise IT or

warfighter communications systems. Areas of expertise should include voice and data

networking, local and wide area networks, network planning and/or cybersecurity. This

experience can be documented through Performance Reports. All applicants much hold a DoD

approved industry certification commensurate with the requirements for the IAT Level II

Certification or higher (previously approved under DoD 8570).

(2) Cyber Effects & Warfare Operations (17Y). Applicants must hold a Senior
Level Proficiency in the United States Cyber Command work role, for the AFSC they are

applying, as defined in the Commands Job Qualification System (or National Security Agency

equivalent), which will be verified prior to the board.

4. Board Application Documents

a. Eligibility Determination Questionnaire (Attachment 1). This is mandatory for all
applicants and must include the commander’s signature to confirm commander’s support of the

application. The questionnaire will assist in determining eligibility to apply for a warrant officer

appointment or warrant officer commission. Ultimately, it is the applicant’s responsibility to

validate their eligibility to apply with all governing manuals, instructions, and guidance. If

applicants have any ineligibility factors after completing the questionnaire, applicants will

require a waiver. Only one statement will be initialed at the bottom of the page. This

questionnaire must be signed by the applicant and the applicant’s commander and be included in

the source documents packet. If waivers are required, this questionnaire must also be included in

the waiver packet. Note: Deployed commanders cannot recommend in lieu of Home Station

Commander.

b. AF WO Application (Attachment 2). Do NOT change the font or alignment on this form.
Refer to Attachment 3 as an example of how to complete this form. Note: Be sure to complete

name, address, phone and email at top of form.

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c. AF Form 24, Application for Appointment as Reserve of the Air Force or USAF Without
Component. (Attachment 5).

d. Technical Letter of Recommendation (LOR). The technical LOR must come from an
individual who can attest to the applicant’s technical ability and skills. The LOR should convey

the technical attributes of the applicants and how those attributes will apply to the successful

execution of Air Force missions. The recommendation from the endorser will be focused on the

individual’s technical prowess and may include any special skills, projects, and experiences not

annotated elsewhere in the application. It is highly recommended the endorser introduce their

technical background prior to focusing on the applicant. The LOR will not exceed two pages in

length, to include endorsements and must be signed by the writer (digital/electronic or wet

signature authorized). The LOR must contain the writer’s contact information (phone number

and/or email address). Must be dated within 12 months of the board convene date. Must address

the LOR to “ANG Warrant Officer Selection Board WOTS FY6” for the board. For guidance,

use AFH 33-337, Tongue and Quill.

e. Resume. ANG members will submit a chronological resume with their application
package. The resume should be formatted in accordance with AFH 33-337, Chapter 21, Tongue

and Quill.

f. AF Form 4428, Tattoo/Brand/Body Marking Screening/Verification, if applicable
(Attachment 4). This form is required for all applicants who have tattoos and/or piercings that

exceed AF standards per DAFI 36-2903.

5. Board Application Process

a. Application Submission. Applications are to be electronically submitted to NGB A2/6 via

email at NGB.A26.CM.CFM.Org@us.af.mil. The Subject line must read [WOTS FY26 - Wing:

Applying - Last Name, First Initial]. If applying to multiple Wings, all must be listed in section 8

of Attachment 2. See Attachment 7 for available Wings / AFSCs.

Examples: WOTS FY26 – Wing: 175 – Doe, J

WOTS FY26 – Wing: 175, 184 – Doe, J

6. Board Application Package. A complete application package will have a minimum of four

separate designated electronic packets. Please note, if selected, the complete application package

will be used to evaluate the member for potential constructive service credit. Do not exclude any

documents for expediency. Do not submit a PDF portfolio. If any packet exceeds 5MB, split it

into as many sections as needed and apply the same naming convention, e.g., App 2, App 3, Srce

2, Srce 3 etc.

a. AF WO Application Packet (Doe, Jane App 1.pdf) must include the following documents
in the order below in one PDF packet, top to bottom.

1) AF WO Application, Attachment 2. Cannot exceed 5 pages.
2) Technical LOR. The technical LOR must come from an individual who can attest to

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the applicant’s technical ability and skills.

b. Source Documents Packet. (Doe, Jane Srce 1.pdf) must include the following documents
in the order below in one PDF packet, top to bottom.

1) Eligibility Determination, Attachment 1, signed by member and commander
2) High School Diploma or equivalent (if not listed in vMPF career data brief)
3) vMPF Career Data Brief (CDB) print out
4) vMPF Record Review Update (View/Print All Pages)
5) If applicable, all college transcripts
6) If applicable, all technical certifications
7) Resume
8) If applicable, AF Form 4428, Attachment 4
9) If applicable, Pregnancy MFR, Attachment 6
10) AF Form 422 (if applicable, Form FL4 ALC Approved Waiver)
11) Other Misc. items as identified (e.g., AFROTC non-contractual memo, Reenlistment

letter of intent, SRB, etc.)

c. AF Form 24. (Doe, Jane AF Form 24.pdf) must include all pages.

d. Performance Evaluation Packet. (Doe, Jane EPB 1.pdf) must include all performance
evaluations (official, closed out, and signed) in chronological order with the most current on top.

Draft copies will not be accepted for overdue EPBs. Draft copies required from any closeout

within 3 months of application due date. If first report/brief exceeds 5MB, split into as many

sections as needed and apply the same naming convention, e.g., EPB 2, EPB 3, etc. If at least

one evaluation is not available due to TIS/TIG requirements, then one AF Form 77, Letter of

Evaluation signed by the squadron commander or equivalent is mandatory.

e. Waiver/ETP Packet, if applicable. Include waiver type in name of saved file, e.g., Doe,
Jane TOS/785/Morals/Art 15 Waiver.pdf. Must include the following documents in the order

below in one PDF packet, scanned top to bottom. Refer to DAFMAN 36-2032 Attachment 1

for more details on waivers and exceptions to policy.

1) Eligibility Determination, Attachment 1, signed by member and Commander.
2) Request memorandum, as required by Eligibility Determination Worksheet.
3) Supporting documentation, i.e., court documents, DD Form 785, Article 15

documents, etc. NOTE: All Waivers, e.g., DD Form 785, Moral, etc., requests are

submitted with the application.

7. Board Selection Timeline. Application Cut Off date – 2 June 2025; NGB Review Start date

– 3 June 2025; Wing Board Start date – 23 June 2025; Estimated Board Release date – 21 July

2025. All applications must be complete and sent to NGB A2/6 no later than (NLT) midnight

Eastern Standard Time of the cut-off date 2 June 2025.

8. Warrant Officer Training School. Individuals selected for a warrant officer appointment or

warrant officer commission will receive reporting instructions and follow-on instructions

concerning WOTS attendance. Applicants can only have one active application with AFRS at

any given time (cannot apply for OTS and WOTS at same time). Following WOTS graduation,

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Warrant Officers will incur a 5-year Reserve Service Commitment.

9. Reapplication. Non-select applicants may reapply to a future WO Board. Non-selects will

not automatically be rolled to the next board. A new application submission is required based on

eligibility at that time.

10. Post Board Actions. Selects will be announced through official notification. The member’s

Commander will have no more than 5 duty days from date of notification to notify members of

their selection before public release.

11. Points of Contact. The ANG is committed to developing our top performing Airmen to

lead tomorrow’s Air Force. The points of contact for the ANG Warrant Officer Program are:

17X Deputy Career Field Manager at NGB.A26.CM.CFM.Org@us.af.mil.

12. Additional Information. For more information and supporting documents, please refer to

the myFSS Knowledge Article (KA #10376) located here:

https://myfss.us.af.mil/USAFCommunity/s/knowledge-detail?pid=kA0Rw0000000LqrKAE

//SIGNED//

Director, NGB/A1

Manpower, Personnel, Recruiting,

and Services

7 Attachments:

1. Eligibility Determination Worksheet
2. AF Warrant Officer Application
3. AF Warrant Officer Application Example
4. AF Form 4428
5. AF Form 24
6. Pregnancy Memo for Record
7. Warrant Officer Positions by State / Wing

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Ensure that all records created as a result of processes prescribed in this message are

maintained in accordance with (IAW) AFI 33-322, Records Management and Information

Governance Program, and disposed of IAW Air Force Records Disposition Schedule (RDS)

located in the Air Force Records Information Management System (AFRIMS)

Privacy Act of 1974 Applies

Eligibility Determination Worksheet

Rank and Full Name: Contact Number:
Unit of Assignment: Duty E-mail:
Commander’s Rank, Name, and Official E-mail:

Answer the following questions: YES NO N/A Eligibility Status Waiver Required

1 Are you a United States citizen? ( AFMAN 36-2032, paragraph 5.4.2.1) No

2
Are you being recommended by your commander for a
commission ?
( AFMAN 36-2032, Table 10.6, Rule 13)

No

3 Are you currently eligible for enlistment or appointment? ( AFMAN 36-2032 Chapter 5 and AFI 36-2606)
No

aiverable
esearch options.

4
Are you currently world-wide qualified and meet all accession
and retention standards without any waivers?
( AFMAN 36-2032, Table 10.1, Rule 28 and 48-123)

No

4a
Do you currently have an Assignment Limitation Code (ALC) of C-1, C-2, or
C-3?

( )

5
Are you able to complete and pass all components of the AF
physical fitness test without any waivers?
(

No

6
Are you a Conscientious Objector as defined by 50 USC §
3806(j), and DoDI 1300.06?
( AFMAN 36-2032, paragraph 5.4.3)

Yes

7
o you have law violations that render you ineligible to

apply as outlined in AFMAN 36-2032, Attachment 2 Yes

8

Have you ever been convicted or found guilty in a juvenile
adjudication for a felony crime f rape, sexual abuse, sexual
assault, incest, or other sexual offen e, or have you required to
register as a sex offender?
( AFMAN 36-2032 paragraph 5.4.5.2)

Yes

9
Have you ever been convicted of domestic battery and/or
domestic violence?
( AFMAN 36-2032, Table A2.2)

Yes

10

Do you currently have a security clearance investigation
reflecting “Action Pending” in JPAS or had a security clearance
denied or revoked?
( AFMAN 36-2032, Table 10.6, Rule 5)

Yes

11

Are you currently under investigation or undergoing court-
martial or civilian criminal court proceedings (includes Airmen
who refuse punishment under Article 15 of the Uniform Code of
Military Justice and request trial by court-martial).
( AFMAN 36-2032, Table 10.6, Rule 6)

Yes

Complete this questionnaire to determine your eligibility and waiver requirements, if any. Validate your commander supports and recommends you for
a warrant officer commission and have them review, sign, and date this form. Submit this form with your Source Documents Packet. If you require a
waiver you must submit this form ith the Waiver Packet as well. If you are ineligible you must check the “waiver required” block and initiate a waiver.
Reference the AD OTS PA chapter 4 for waiver processing. Only create a waiver packet for a requiring a memo.

Privacy Act of 1974 Applies

12 Are you currently on a control roster? ( AFMAN 36-2032, Table 10.6, Rule 7) Yes

13

Are you being considered for involuntary separation/discharge,
or have applied for the Temporary Early Retirement Authority
(TERA) or Voluntary Separation Pay (VSP), or are scheduled to
separate or retire under any Force Management Programs?
( AFI 36-32 )

Yes

14

Do you have any obscene or offensive tattoos, brands, or
body markings that advocate sexual, racial, ethic, or
religious slurs or do you have any body modification or
alteration that detracts from a professional military
image? ( AFI 36-2903, paragraph 3.4.1)

Yes

15

Yes

16

Have you been selected for assignment?

If yes, enter your RNLTD:
( AFMAN 36-2032, Table 10.6, Rule 1)

-For Informational Purposes Only-

• Is this is OS assignment?

• Is this a short or long tour?

• What is your actual or projected final out date:

• Are you on an AAC50? If yes, exp. Date:

Yes

17
Have you been selected for or are enrolled in a course leading to
an award of an AFSC? (Tech School, Retraining)
( AFMAN 36-2032, Table 10.6, Rule 2)

Yes

18
Do you have less than one (1) year of continuous service in the
Air Force as of the ?
( AFMAN 36-2032, Table 10.6, Rule 3)

Yes

19 No

20 No

21 Have you previously received a commission in any of the Uniformed Services listed in AFMAN 36-2032 ( 10.6, R 8)

22
Have you ever held a commission in any of the Uniformed
Services, but did not attend a commissioning program listed in
AFMAN 36-2032, Attachment 24?
( AFMAN 36-2032, Table 10.6, Rule 9)

Yes

Not applicable to ANG

Not applicable to ANG

Privacy Act of 1974 Applies

23

Are you a USAFA or AFROTC involuntarily called
to active duty, and have not served one-half (1/2) of your term
of enlistment?
( AFMAN 36-2032, Table 10.6, Rule 11)

Yes

24

Have you requested withdraw of your application or had a
waiver request disapproved within the last six (6) months?
( AFMAN 36-2032, Table 10.6, Rule 12)

Yes

25

Have you declined selection or had your selection involuntarily
withdrawn within the last six (6) months?
( AFMAN 36-2032, Table 10.6, Rule 12)

Yes

26

27

28

Have you ever been disenrolled from any military service
academy OR from any other officer training program in

AFMAN 36-2032, Attachment 9 as defined in AFMAN
36-2032 paragraph 5.4.8.3.1?

Yes

29 Do you have a drug or alcohol abuse problem as defined in AFMAN 36-2032 paragraph 5.4.11 and/or AF 48-123

Yes

30

Do you

No

31

Do you meet the minimum AFOQT scores as outlined in
AFMAN 36-2032, Table 5.1?

Verbal: 15 or higher
Quantitative: 10 or higher

Pilot and RPA: Pilot sub-section score: 25 or
higher CSO: CSO/Navigator sub-section score: 25 or
higher ABM: A sub-section score: 25 or higher

No

32

Do you have a PCSM score of 10 or
higher? ( AFMAN 36-2032, Table 5.1, Rule 2)

No

33

Will you be 33 or older as of the board release date?
(AD OTS PA, Attachment 1 , HQ USAF/A1P Memo)

Yes

Not applicable for Warrant Officer

Not applicable for Warrant Officer

Not applicable for Warrant Officer

Not applicable for Warrant Officer

Privacy Act of 1974 Applies

34 Are you under the age of 18? (AFMAN 36-2032, paragraph 5.4.6.1)

Yes

35

fter subtracting your are you eligible to
serve as a commissioned for at least 10 years
( AFMAN 36-2032, paragraph 5.4.6.1.3.2)

No

36

Do you have a qualifying AF Form 422 with the mandatory
statement as outlined in the AD OTS PA?
(AD OTS PA, Chapter 6)

No

37

Are you a Nonnative English-Speaking (NES) applicant as
defined in AFMAN 36-2032 paragraph 7.3.2? If so, you must
follow the guidance in AFMAN 36-2032 Table 7.1
( AFMAN 36-2032 paragraph 7.3.2)

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Have you identified any other disqualifying factor(s) that
require(s) a waiver? If yes, list them here:

Statement of Understanding

I certify the information provided on this form is true and correct to the best of my knowledge.

Date Applicant's Signature

Unit Commander or Equivalent Indorsement
I reviewed this questionnaire and concur with the results.

Date

Privacy Act of 1974 Applies AFRS/RSOC 17 Jun 20

AF WO Application

1. What are your objectives and reasons for desiring to become a Warrant Oficer?

2. What leadership attributes do you possess that would make you a good officer?

Privacy Act of 1974 Applies AFRS/RSOC 17 Jun 20

3. Work Experience (list last 4 jobs only in chronological order with most current first)
From (MM/YY) To (MM/YY) Position Held Part-Time / Full-Time

Company Name and Address Did you supervise people?

If yes, how many people?

Duties/Responsibilities/Accomplishments (list in single line format with four (4) lines)

From (MM/YY) To (MM/YY) Position Held Part-Time / Full-Time

Company Name and Address Did you supervise people?

If yes, how many people?

Duties/Responsibilities/Accomplishments (list in single line format with four (4) lines)

From (MM/YY) To (MM/YY) Position Held Part-Time / Full-Time

Company Name and Address Did you supervise people?

If yes, how many people?

Duties/Responsibilities/Accomplishments (list in single line format with four (4) lines)

From (MM/YY) To (MM/YY) Position Held Part-Time / Full-Time

Company Name and Address Did you supervise people?

If yes, how many people?

Duties/Responsibilities/Accomplishments (list in single line format with four (4) lines)

Privacy Act of 1974 Applies AFRS/RSOC 17 Jun 20

4. Education (Mark N/A if none)
Grad Date (MM/YY) Degree Type (B.S./B.A.) GPA Major/Degree Title

5. Additional Education (Mark N/A if none)
Grad Date (MM/YY) Degree Type (A.A./M.S.) GPA Major/Degree Title

Certifications/Licenses and Date (List Any Current/Valid Certifications/Licenses and Expiration Date in MM/YY
format/e.g.: PPL / 02/25) (LIMITED to six (6) entries)

6. Significant Professional/Personal/Academic Achievements (e.g.: Employer recognition, Dean’s List
recipient, Summa/Magna Cum Laude, etc./do NOT list hobbies, LIMITED to ten (10) entries)

7. If you ever applied to a program that leads to a commission in any component of the US
Armed Forces, list it here (Include Service Academies, ROTC, OTS/OCS, etc.)
Date Enrolled or Applied (MM/YY) Program/ROTC/Academy Name Final Disposition

7a. Explanation for declination, withdrawal, failure, etc. (A non-select does NOT need to be addressed)

Privacy Act of 1974 Applies AFRS/RSOC 17 Jun 20

8. Wing / AFSC Applying. List in order of preference/Maximum of one (1) per line. List in this format: Wing / AFSC
(example: 184 WG / 17Y).

Preference 1.

Preference 2.

Preference 3.

Preference 4.

Preference 5.

Preference 6.

Preference 7.

Preference 8.

9. Statements of Understanding (Rated Applicants Only) (Leave Blank for WO board)
I understand if selected for Pilot, I will incur a ten (10) year service commitment and if selected for
ABM, CSO, or RPA I will incur a six (6) year service commitment.

I understand, if selected I must complete an Initial Flying Class (IFC) Physical within 120 days of
the official board release (notification) date or I risk my selection status being withdrawn.

10. Law Violations (List any and all law violations in chronological order with the most recent first)
(Recruiters must ensure this data matches AFRISS-TF)
Offense Date (MM/YY) Offense Final Disposition

This application is true and correct to the best of my knowledge. _______________________________
Applicant’s Signature/Date

Privacy Act of 1974 Applies AFRS/RSOC 17 Jun 20

-Prior Military Service Applicants Only-

11. Prior Service? (If yes, attach the back of your last four performance reports, with most current on top)
From (MM/YY) To (MM/YY) Branch/Component Highest Pay Grade Held AFSC/MOS Held

12. Professional Military Education (List all levels of PME completed (ALS, NCOA, etc.)
Grad Date (MM/YY) Type (ALS/NCOA, etc.) Base Attended Award(s) Received

-This page may be deleted if not used-

Privacy Act of 1974 Applies AFRS/RSOC 17 Jun 20

AF WO Application

1. What are your objectives and reasons for desiring to become a Warrant Officer?

2. What leadership attributes do you possess that would make you a good officer?

EXAMPLE

Privacy Act of 1974 Applies AFRS/RSOC 17 Jun 20

3. Work Experience (list last 4 jobs only in chronological order with most current first)
From (MM/YY) To (MM/YY) Position Held Part-Time / Full-Time

Company Name and Address Did you supervise people?

If yes, how many people?

Duties/Responsibilities/Accomplishments (list in single line format with four (4) lines)

From (MM/YY) To (MM/YY) Position Held Part-Time / Full-Time

Company Name and Address Did you supervise people?

If yes, how many people?

Duties/Responsibilities/Accomplishments (list in single line format with four (4) lines)

From (MM/YY) To (MM/YY) Position Held Part-Time / Full-Time

Company Name and Address Did you supervise people?

If yes, how many people?

Duties/Responsibilities/Accomplishments (list in single line format with four (4) lines)

From (MM/YY) To (MM/YY) Position Held Part-Time / Full-Time

Company Name and Address Did you supervise people?

If yes, how many people?

Duties/Responsibilities/Accomplishments (list in single line format with four (4) lines)

Privacy Act of 1974 Applies AFRS/RSOC 17 Jun 20

4. Education (Mark N/A if none)
Grad Date (MM/YY) Degree Type (B.S./B.A.) GPA Major/Degree Title

5. Additional Education
Grad Date (MM/YY) Degree Type (A.A./M.S.) GPA Major/Degree Title

Certifications/Licenses and Date (List Any Current/Valid Certifications/Licenses and Expiration Date in MM/YY
format/e.g.: PPL / 02/25) (LIMITED to six (6) entries)

6. Significant Professional/Personal/Academic Achievements (e.g.: Employer recognition, Dean’s List
recipient, Summa/Magna Cum Laude, etc./do NOT list hobbies, LIMITED to ten (10) entries)

7. If you ever applied to a program that leads to a commission in any component of the US
Armed Forces, list it here (Include Service Academies, ROTC, OTS/OCS, etc.)
Date Enrolled or Applied (MM/YY) Program/ROTC/Academy Name Final Disposition

7a. Explanation for declination, withdrawal, failure, etc. (A non-select does NOT need to be addressed)

Privacy Act of 1974 Applies AFRS/RSOC 17 Jun 20

8. AFSC Preferences. List in order of preference/Maximum of one (1) per line. List in this format: Wing / AFSC
(example: 184 WG / 17Y).
ensure this matches AFRISS-TF in the “Pref.” tab)
Preference 1.

Preference 2.

Preference 3.

Preference 4.

Preference 5.

Preference 6.

Preference 7.

Preference 8.

9. Statements of Understanding (Rated Applicants Only) (Leave Blank for WO Board)
I understand if selected for Pilot, I will incur a ten (10) year service commitment and if selected for
ABM, CSO, or RPA I will incur a six (6) year service commitment.

I understand, if selected I must complete an Initial Flying Class (IFC) Physical within 120 days of
the official board release (notification) date or I risk my selection status being withdrawn.

10. Law Violations (List any and all law violations in chronological order with the most recent first)
(Recruiters must ensure this data matches AFRISS-TF)
Offense Date (MM/YY) Offense Final Disposition

This application is true and correct to the best of my knowledge. _______________________________
Applicant’s Signature/Date

Privacy Act of 1974 Applies AFRS/RSOC 17 Jun 20

-Prior Military Service Applicants Only-

11. Prior Service? (If yes, attach the back of your last four performance reports, with most current on top)
From (MM/YY) To (MM/YY) Branch/Component Highest Pay Grade Held AFSC/MOS Held

12. Professional Military Education (List all levels of PME completed (ALS, NCOA, etc.)
Grad Date (MM/YY) Type (ALS/NCOA, etc.) Base Attended Award(s) Received

-This page may be deleted if not used-

TATTOO/BRAND/BODY MARKING SCREENING/VERIFICATION

SECTION I. AIRMAN

AF FORM 4428, 20110831 PREVIOUS EDITIONS ARE OBSOLETE

Number on
Body Diagram

Location Description, Size, Shape and Meaning

SECTION II. IDENTIFICATION

a. LAST NAME - FIRST NAME - MIDDLE INITIAL (SUFFIX) b. DATE OF BIRTH (YYYYMMDD) c. SOCIAL SECURITY NUMBER

PRIVACY ACT STATEMENT

ROUTINE USE: Disclosures generally permitted under 5 U.S.C. 552a(b) of the Privacy Act. DoD 'Blanket Routine Uses' apply.

AUTHORITY: 10 U.S.C. 8013, Secretary of the Air Force, Executive Order 9397 (SSN), as amended.

PURPOSE: To provide personnel management support to commanders and supervisors.

DISCLOSURE: Voluntary, failure to provide SSN may impede proper placement in member's military personnel file.

The information you have given constitutes an official statement. Federal law provides severe penalties (up to 5 years confinement or a

$10,000 fine or both), to anyone making a false statement. If you knowingly and willingly provide a false statement you can be tried by military courts

• martial or meet an administrative board for discharge and could receive a less than honorable service characterization.

WARNING:

Initials

Commander marks all tattoo/brand/body markings with a number and Airman initials

Commander describes tattoo/brand/body marking information below and Airman initials
 

Front Back

PRIVACY ACT INFORMATION: The information in this form is

FOR OFFICIAL USE ONLY. Protect IAW the Privacy Act of 1974.

DATE NAME (Last, First, M.I.)RANK/GRADE

DATE NAME (Last, First, M.I.)RANK/GRADE

SECTION V. COMMANDER'S ACTION

SIGNATURE

AIRMAN ACKNOWLEDGEMENT

SIGNATURE

INITIALS

SECTION II. TATTOO/BRAND/BODY MARKING IDENTIFICATION OVERFLOW

DATE NAME (Last, First, M.I.) RANK/GRADE

FIRST SERGEANT

I CERTIFY THE ABOVE INDIVIDUAL SIGNED THIS CERTIFICATE

SIGNATURE

AF FORM 4428, 20110831 PREVIOUS EDITIONS ARE OBSOLETE.

SECTION III. AIR FORCE TATTOO/BRAND/BODY MARKING POLICY

Unauthorized (content): Tattoos/brands/body markings anywhere on the body that are obscene, commonly associated with gangs, extremist, and/or

supremacist organizations, or that advocate sexual, racial, ethnic, or religious discrimination are prohibited in and out of uniform.

Excessive tattoos/brands/body markings will not be exposed or visible (includes visible through the uniform) while wearing any/all uniform combination(s)

except the PTU. This includes any combination of short sleeve, long sleeve, open collar uniform, utility uniform sleeves rolled up or worn down, flight duty

uniform, etc. This policy does not apply when wearing the PTU. Excessive is defined as any tattoos/brands/body markings that exceed 1/4 (25%) of the

exposed body part and are readily visible when wearing any/all uniform combination(s).

The exposed body part is defined as the total area, to include front, sides and back of limb or other body part protruding from a uniform item.

DATE Airman NAME (Last, First, M.I.)

DATE NAME (Last, First, M.I.) RANK/GRADE

SECTION IV. INITIAL CERTIFICATION

I hereby certify that the markings in section II are a true and accurate representation of all tattoos/brands/body markings.

I have read and fully understand the information contained on this form and have been briefed on Air Force tattoo/brand/body marking

policy.

SIGNATURE

SUPERVISOR

I CERTIFY THE ABOVE INDIVIDUAL SIGNED THIS CERTIFICATE

SIGNATURE

INITIALS

There is no additional tattoo/brand/body marking information for this section. Airman Initials: _____________

The tattoo/brand/body marking complies with policy and is approved.

The tattoo/brand/body marking does not comply with policy and requires further action IAW AFI 36-2903.

RANK/GRADE

PRIVACY ACT INFORMATION: The information in this form is

FOR OFFICIAL USE ONLY. Protect IAW the Privacy Act of 1974.

AF FORM 4428, 20110831 PREVIOUS EDITIONS ARE OBSOLETE.

No additional tattoo/brand/body marking information for this page. Airman Initials: _____________

SECTION II. TATTOO/BRAND/BODY MARKING IDENTIFICATION

a. LAST NAME - FIRST NAME - MIDDLE INITIAL (SUFFIX)

PRIVACY ACT INFORMATION: The information in this form is

FOR OFFICIAL USE ONLY. Protect IAW the Privacy Act of 1974.

OMB NO. 0701-0096

APPOINTMENT AS A RESERVE
MEMBER OF THE AIR FORCE

APPOINTMENT AS A USAF MEMBER
WITHOUT COMPONENT

PRIVACY ACT STATEMENT
AUTHORITY: 10 U.S.C. 591, Reserve Components Qualifications; Executive Order 9397 (SSN), as amended.
PRINCIPAL PURPOSE: Provides necessary information to determine if applicant meets qualifications established for appointment as a Reserve (ANGUS and
USAFR) or in the USAF without component. Use of SSN is necessary to make positive identification of an applicant and his or her records.
ROUTINE USE: May specifically be disclosed outside the DoD as a routine use pursuant to 5 U.S.C. 552a(b)(3).
DISCLOSURE: Disclosure is voluntary. If information is not provided, all further processing is terminated.

AGENCY DISCLOSURE STATEMENT
Public reporting burden for this collection of information is estimated to average 20 minutes per response, including the time for reviewing instructions, searching
existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this
burden estimate or any other aspect of this collection of information, including suggestions for reducing the burden, to Department of Defense, Washington
Headquarters Services, Executive Services Directorate, Information Management Division, 4800 Mark Center Drive, East Tower, Suite 02G09, Alexandria, VA
22350-3100 (0701-0096). Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to
comply with a collection of information if it does not display a currently valid OMB control number.

INSTRUCTIONS
Complete this form in two copies. Use typewriter or print clearly in ink. Sign each copy separately. Check the type of appointment, under the form title, for
which you are applying. Upon termination from active duty, travel entitlements are based on the information you enter in item 6, "Home of Record (HOR) ."
Once recorded, the HOR may not be changed. If additional space is required, continue in item 33, "Remarks."
1. TO : 2. SPECIALTY

3. FROM: (Last, First, Middle Initial) 4. SSN 5. DATE OF BIRTH (YYYYMMDD)

6

6. HOME OF RECORD (HOR) (Include ZIP Code and 4 digit) (If a postal box include
your street address)

7. PLACE OF BIRTH (City, State, Country)

8

8. MAILING ADDRESS (If other than HOR, include ZIP Code and 4 digit) (If a postal
box include your street address)

9. PERSON TO BE NOTIFIED IN CASE OF EMERGENCY (Name, relationship,
and address)

10. MARITAL STATUS SINGLE MARRIED TO MILITARY MEMBER MARRIED TO CIVILIAN SEPARATED DIVORCED WIDOWED

11. FAMILY MEMBERS 12. U.S. CITIZEN YES BIRTH NATURALIZED(Other than spouse, number
IF YOU ARE U.S. CITIZEN BY OWN NATURALIZATION, STATE THE DATE, NUMBER OF CERTIFICATE, AND COURTcompletely dependent upon you)

13. I UNDERSTAND I AM BEING CONSIDERED FOR APPOINTMENT:

To fill an active force requirement and agree to remain on active duty for the period specified in pertinent instructions (AFIs 36-2008, 36-2011 and 36-2107).

Require at least 30 days notice to enter
active duty.

My geographic preference of
assignment is:

I will be available to enter
active duty on:

I do

I do not

To fill an authorized position vacancy in the Ready Reserve.
INITIALS I further understand that if I have not previously incurred a military service obligation (MSO), that I will incur an MSO and I have been briefed on

what my MSO will be.

INITIALS I have been briefed on my responsibility to participate in the Air Force Direct Deposit Program within 60 days of arrival at my first permanent duty station.

INITIALS I have been briefed on the contents of the application briefing item on separation policy..

14. EDUCATION
TYPE OF
SCHOOL

DATES ATTENDED NO. YRS
COMPL

GRAD TYPE OF
DEGREEMAJOR SUBJECTNAME OF SCHOOL YFROM (YMD) TO (YMD) N

SECONDARY
AND OTHER

COLLEGE,
POST-

GRADUATE,
INTERNSHIP,
RESIDENCY,

FELLOWSHIP,
ETC.

MILITARY

15. OTHER SUBJECTS SPECIALIZED IN (Include certification by American Specialty Boards and date of certification)

PREVIOUS EDITIONS ARE OBSOLETE PAGE 1 OF 4 PAGESAF FORM 24, 20100622

NO (If yes, check appropriate item)

FEDERAL RECOGNITION AND APPOINTMENT
AS A RESERVE MEMBER OF THE AIR FORCE

APPLICATION FOR APPOINTMENT AS RESERVE OF THE AIR FORCE
OR USAF WITHOUT COMPONENT

16. PHYSICIANS ONLY

I DO DO NOT DESIRE TRAINING IN AVIATION MEDICINE
17. CHRONOLOGICAL STATEMENT OF SERVICE AND TRAINING IN ANY COMPONENT OF THE UNIFORMED SERVICES (Include service academies and
preparatory schools, Reserve Officer Training Crops (ROTC), Officer Training School (OTS), Health Professions Scholarship (HPSP), etc.)

HIGHEST

GRADE

ORGANIZATION ACTIVE DUTY

OR RESERVE

DATES ATTENDED
SPECIALTY

FROM TO (Type and Service)(YMD) (YMD)

18. ARE YOU CURRENTLY A MEMBER OF ANY BRANCH OF THE UNIFORMED SERVICES? 19. WERE ALL DISCHARGES HONORABLE?

YES NO (If yes, provide branch of uniformed service) YES NO

20. WERE YOU EVER NONSELECTED FOR PROMOTION TO AN OFFICER GRADE IN ANY BRANCH OF THE UNIFORMED SERVICES?

YES NO (If yes, provide branch of uniformed service)

21. WERE YOU SEPARATED OR ARE YOU PENDING SEPARATION FROM ANY BRANCH OF THE UNIFORMED SERVICES FOR CAUSE, OR WERE YOU
SEPARATED OR ARE YOU PENDING SEPARATION FROM COMMISSIONED STATUS IN ANY BRANCH OF THE UNIFORMED SERVICES DUE TO
NONQUALIFIED, NONSELECT, OR DEFERRAL PROMOTION?

YES NO (If yes, provide branch of uniformed service, reason for separation action, and date of separation, if applicable)

22. HAVE YOU EVER RECEIVED SEVERANCE PAY, OR SEPARATION PAY, OR READJUSTMENT PAY, OR VOLUNTARY SEPARATION INCENTIVE (VSI) OR
SPECIAL SEPARATION BENEFIT (SSB) PAY WHEN RELEASED FROM ACTIVE DUTY OR DISCHARGED FROM ANY UNIFORMED SERVICE?

YES NO

23. HAVE YOU PREVIOUSLY MADE APPLICATION AND BEEN REJECTED FOR COMMISSIONING BY ANY COMPONENT OF THE UNIFORMED SERVICES?

YES NO (If yes, please state when and where rejected, and cause)

24. HAVE YOU EVER APPLIED FOR A COMMISSION OR POSITION WITH ANY BRANCH OF THE ARMED SERVICES OR FEDERAL GOVERNMENT? IF SO, PLEASE
EXPLAIN.

(If additional space is required, continue in "REMARKS")YES NO

25. CHRONOLOGICAL STATEMENT OF CIVILIAN EMPLOYMENT, INCLUDING PART-TIME POSITIONS. (If additional space is required, continue in "REMARKS" section)

FROM (YMD) TO (YMD) EMPLOYED BY (Give name and address to include ZIP Code and 4 digit) FULL
TIME

PART TIME MONTHLY SALARY
(Hrs per week)

POSITION AND DUTIES REASON FOR TERMINATION

FROM (YMD) TO (YMD) EMPLOYED BY FULL
TIME

PART TIME MONTHLY SALARY(Give name and address to include ZIP Code and 4 digit)
(Hrs per week)

POSITION AND DUTIES REASON FOR TERMINATION

FROM (YMD) TO (YMD) EMPLOYED BY (Give name and address to include ZIP Code and 4 digit) FULL
TIME

PART TIME MONTHLY SALARY
(Hrs per week)

POSITION AND DUTIES REASON FOR TERMINATION

26. HAVE YOU EVER BEEN INVOLVED, ARRESTED, INDICTED, OR CONVICTED (INCLUDING PRETRIAL DIVERSION) FOR ANY VIOLATION OF CIVIL OR
MILITARY LAW, INCLUDING NONJUDICIAL PUNISHMENT PURSUANT TO ARTICLE 15 OF THE UCMJ, OR MINOR TRAFFIC VIOLATIONS?

(If yes, please explain below. List all offenses charged against you regardless of final disposition, including situations where theYES NO
involvement has not been recorded locally or the record has been ordered sealed or expunged by the court.)

DATEOFFENSE PLACE AGE DISPOSITION OF CHARGE COURT
(YYYYMMDD)

PAGE 2 OF 4 PAGESPREVIOUS EDITIONS ARE OBSOLETEAF FORM 24, 20100622

26a. HAVE YOU EVER BEEN CONVICTED OF A DUI OR ALCOHOL RELATED OFFENSE?

YES (If yes, submit a statement in your own words describing the circumstances, and a copy of the police report.NO
involvement has not been recorded locally or the record has been ordered sealed or expunged by the court.)

DATEOFFENSE PLACE AGE DISPOSITION OF CHARGE COURT
(YYYYMMDD)

(A conscientious objector is defined as: One who has or has a firmed, fixed, and sincere objection to27. ARE YOU A CONSCIENTIOUS OBJECTOR?
participation in war in any form or to bearing of arms because of religious training or belief, which includes solely moral or ethical beliefs.)

YES NO

28. ARE YOU NOW OR HAVE YOU EVER BEEN AFFILIATED WITH ANY ORGANIZATION OR MOVEMENT THAT SEEKS TO ALTER OUR FORM OF GOVERNMENT
BY UNCONSTITUTIONAL MEANS, OR SYMPATHETICALLY ASSOCIATED WITH ANY SUCH ORGANIZATION, MOVEMENT, OR MEMBERS THEREOF?

YES NO (If yes, please describe.)

29. ARE THERE ANY OTHER UNFAVORABLE INCIDENTS IN YOUR LIFE WHICH YOU BELIEVE MAY REFLECT UPON YOUR LOYALTY TO THE UNITED STATES
GOVERNMENT OR UPON YOUR ABILITY TO PERFORM THE DUTIES WHICH YOU MAY BE CALLED UPON TO UNDERTAKE?

YES NO (If yes, please describe.)

30. HEALTH CARE PRACTITIONERS AND JUDGE ADVOCATE APPLICANTS ONLY

A. LIST ALL STATE OR FEDERAL BAR LICENSES HELD CURRENTLY OR AT ANY TIME IN THE PAST

STATE IN WHICH LICENSED DATE LICENSED EXPIRATION DATE STATE IN WHICH LICENSED DATE LICENSED EXPIRATION DATE

B. APPLICANT MUST INITIAL EACH QUESTION

(1) HAVE YOU EVER HAD ANY OF THE ABOVE STATE LICENSE (S) SUSPENDED OR REVOKED?

(Initials) YES NO (If yes, please explain in "REMARKS.")

(2) HAVE YOU EVER VOLUNTARILY SURRENDERED OR FAILED TO RENEW ANY OF THE ABOVE STATE LICENSES?

(Initials) YES NO (If yes, please explain in "REMARKS.")

(3) HAVE YOU EVER HAD ANY MEDICAL CLAIMS, SETTLEMENTS, JUDICIAL, OR ADMINISTRATIVE ADJUDICATION, OR GRIEVANCES, OR ANY OTHER
RESOLVED OR OPEN CHARGES OF INAPPROPRIATE, UNETHICAL, UNPROFESSIONAL, OR SUBSTANDARD MEDICAL CARE OR LEGAL MALPRACTICE?

(Initials) YES NO (If yes, please explain in "REMARKS.")

(4) HAVE YOU EVER HAD YOUR PROFESSIONAL PRIVILEGES WITHDRAWN, DENIED, OR RESTRICTED BY ANY HEALTH CARE INSTITUTION OR
STATE BAR LICENSING ORGANIZATION, OR HAVE YOU EVER VOLUNTARILY SURRENDERED YOUR PRIVILEGES?

(Initials) YES NO (If yes, please explain in "REMARKS.")

(5) ARE YOU BOARD CERTIFIED?

(Initials) YES NO (If no, please explain in "REMARKS.")

(6) ARE YOU BOARD ELIGIBLE?

(Initials) YES NO (If no, please explain in "REMARKS.")

(7) HAVE YOU EVER TAKEN THE WRITTEN AND/OR ORAL PORTION OF YOUR BOARD OR BAR EXAMINATION AND FAILED?

(Initials) YES NO (If yes, please explain in "REMARKS.")

(8) DO YOU PLAN TO TAKE OR RETAKE YOUR BOARDS OR BAR EXAMINATION IN THE FUTURE?

(Initials) YES NO (If yes, when? please explain in "REMARKS.")

31. AFOQT SCORES (Only AFTCOs or Unit Commanders are authorized to enter scores)

DATE TESTEDAFOQT FORM PILOT NAV TECH AA VERBAL QUANTITATIVE

32. SECURITY CLEARANCE (X as applicable)

NONE PENDING: DATE INITIATED (YYYYMMDD) GRANTED: TYPE: DATE GRANTED

33. REMARKS (If additional space is needed, continue on page 4. Be sure to identify item number.)

I understand that any false or incomplete information knowingly provided on or with this application may be grounds for not employing or accessing with the
Air Force, or grounds for dismissing or releasing me from active duty if already employed or serving.

DATENAME (First, Full Middle, Last Name) (Typed or Printed) SIGNATURE (First, Full Middle, and Last Name)

PREVIOUS EDITIONS ARE OBSOLETEAF FORM 24, 20100622 PAGE 3 OF 4 PAGES

ADDITIONAL COMMENTS OR EXPLANATIONS

ITEM

NO.
IDENTIFY THE ITEM NUMBER AND EXPLAIN IN THIS SPACE (If additional space is required, use full sheets of paper. Write your name and SSN on each
sheet.)

(initial)1. "I have read and understand HQ USAFRS FS

2. Short Notice Orders

"I have been briefed on and understand the following":

a. Shipment of household goods is dependent upon receipt of my active duty orders and availability of a common carrier arranged through a local

military Traffic Management Office (TMO). (initial)

b. If I receive my active duty orders less than 30 days from entering active duty, I may not be able to ship household goods prior to my departure for
training at Maxwell/Gunter Air Force Base, Alabama, or my permanent duty station. If this causes undue hardship, I understand that a change to my
reporting date may be requested (initial)

c. Should I need to return to my current residence to ship household goods or pickup Family Members, I will be responsible for any travel expenses
above those associated with traveling from Maxwell/Gunter Air Force Base, Alabama, to my permanent duty station. Also, any additional time taken over
authorized travel time will be charged as leave (initial)

PREVIOUS EDITIONS ARE OBSOLETE.AF FORM 24, 20100622 PAGE 4 OF 4 PAGES

AF FORM 24 CONTINUATION SHEET

PREVIOUS EDITIONS ARE OBSOLETEAF FORM 24, 20100622

CUI

CUI

(Appropriate letterhead)
Date:

MEMORANDUM FOR: HQ AFRS/RSOCL



FROM: ORG/SYMBOL

SUBJECT: Contractual Statement for Pregnant Warrant Officer Training School Candidates

SUBJECT: Request for Access to AFCEP for WOTSXX Board Application Submission



1. This memorandum outlines the required contractual statement for pregnant Warrant Officer Training
School candidates applying to an upcoming Warrant Officer Selection Board.

2. I understand that no sooner than 6 months and no later than 14.5 months upon post-pregnancy
completion, I must establish world-wide deployment medical clearance to include a passing full
component PT test (no exemptions authorized) prior to being scheduled for a Warrant Officer Training
School class date. If I desire a date prior to 6 months, I may request a waiver IAW with the
process outlined at paragraph 7.5.3.2.6. If I fail to meet the above timelines, I will lose my
Warrant Officer Training School selection status.

3. If you have any questions or concerns, please contact me at XXX-XXX-XXXX.

___________________________________
Signature

Signature Block