warrant officer (gunner) application

WARRANT OFFICER (GUNNER) APPLICATION

This document provides instructions and forms to complete a Warrant Officer (Gunner) application. Send your completed package to [email protected] via encrypted email ONLY AFTER THE APPLICATION IS COMPLETE, including signed endorsements. Attach the application package and medical submission as two (2) pdf documents. The subject line of the email should be: WO (Gunner) Application ICO Rank LNAME, FNAME MI EDIPI/PMOS.

Templates and electronically fillable forms are both provided in this application. Use whichever is preferred as long as every applicable item on the checklist is included in your application package.

To assemble your package, use the steps below:

1. After reading the current MARADMIN, MCO and SECNAVINST, utilize the checklist to highlight which items are applicable to you.

2. The first command endorsement is provided as a template aswell as in fillable format. If using the electronic form,refer to the template for guidance. The rest of theendorsements should follow standard naval format.

3. Complete and sign your application letter. A templateapplication letter is provided as well as a fillable formwhich can be signed electronically.

4. Complete the top half of the data sheet.

5. Ensure a promotion type photo has been included in yourpackage and submitted to MMRP for inclusion in OMPFwithin a year of the board date.

6. Provide certified copies of the following Marine CorpsTotal Force System (MCTFS) screens: BIR/BTR, Education,Awards, Chronological Order, Test Score Screen.

7. Provide official test scores as applicable.

8. Sign and date the NAVMC 118(11) fraternization statement.Include with certified copy of all SRB page 11 entries.

7. Attach essay as an enclosure.

mailto:[email protected]

11. If applicable, provide non-judicial punishment(s) NJP(s)and a statement addressing the 5 w’s of the incident(s).

12. If you have or ever have had tattoos, brands, bodymarkings, or body ornamentation, provide the appropriate color photo or drawing (only for areas not visble in PT gear) for screening.

13. If applicable, provide any page 11’s documenting yourtattoo(s).

14. Letters of recommendation, letters to the boardpresident, professional certificates/certifications, and college degrees and/or transcripts may be attached as applicable.

15. If dual or naturalized citizen, provide a copy of yourbirth certificate or other required citizenship documents (if BIR reflects citizenship as alien).

10. Complete the tattoo screening form and tattoostatement of understanding.

9. Use the template or fillable form to provide a signed security clearance verification letter. Security clearance must not expire before the projected appointment date. JPASS printouts ARE NOT authorized.

To submit, compile all printed documents and scan into ONE (1) PDF file. This application file should contain all required documents IN THE SAME ORDER as the checklist. Your medical documents will likewise be combined into ONE (1) PDF file, correctly ordered and scanned. The application and medical documents should be sent in one email and the attachments must not exceed a combined file size of 10 MB.

Refer to the website and MARADMIN for further instructions.

ENLISTED TO WARRANT OFFICER PROGRAM CHECKLIST

• REQUIRED DOCUMENTS:

____ COMMAND ENDORSEMENTS (MUST HAVE FAVORABLE ENDORSEMENT FROM CG IN CHAIN OF COMMAND TO BE SUBMITTED)

____ APPLICANT’S APPLICATION

____ DATA SHEET

____ PHOTO

____ ESSAY

____ MCTFS SCREENS (BIR/BTR, EDUCATION, AWARDS, CHRONOLOGICAL ORDER, TEST)

____ ACT/SAT TEST SCORES (IF APPLICABLE)

____ p.11 w/FRATERNIZATION STATEMENT

____ SECURITY CLEARANCE VERIFICATION LETTER

____ TATTOO SCREENING FORM/STATEMENT OF UNDERSTANDING

WAIVER:____ NON-JUDICIAL PUNISHMENT AND STATEMENT (ADDRESSING 5 W’s)

•

____ TATTOO PHOTOS/DRAWINGS (COLOR PHOTOS REQUIRED), DESCRIPTIONS AND MEASUREMENTS (USE TATTOO TOOL FOR TATTOOS NEAR ELBOW AND KNEE)

NOTE: TATTOO TOOL CAN BE FOUND IN MCBUL 1020

____ TATTOO PAGE 11 (IF APPLICABLE)

• OPTIONAL DOCUMENTS:

____ LETTERS OF RECOMMENDATION

____ LETTER TO THE BOARD PRESIDENT

____ PROFESSIONAL CERTIFICATES/CERTIFICATIONS

____ COLLEGE DEGREES AND/OR TRANSCRIPTS

____ PROOF OF CITIZENSHIP (IF DUAL OR NATURALIZED CITIZEN)

• MEDICAL:

____ PRECOMMISSIONING PHYSICAL – DD FORM 2807-1/DD FORM 2808

ENDORSEMENTS

REQUIRED:

• ALL MARINES ARE REQUIRED TO OBTAIN A COMMANDER’S ENDORSEMENTAT EACH LEVEL OF COMMAND (UP TO THE FIRST GENERAL OFFICER IN THE MARINE'S ENDORSING CHAIN OF COMMAND)

• COMMANDERS MUST ENSURE THAT THEIR ENDORSEMENT, DENOTINGTHEIR LEVEL OF CONFIDENCE, IS PROMPTLY RETURNED TO THEMARINE PRIOR TO THE APPLICATION DEADLINE. COMMANDS ARE NOLONGER AUTHORIZED TO MAIL THEIR ENDORSED APPLICATIONS TOMCRC SINCE THE MARINE SUBMITS THEIR OWN APPLICATION VIAENCRYPTED EMAIL TO [email protected].

• COMMANDS MUST ENSURE THAT ALL MARINES RECEIVE ORIGINALS OFTHEIR LETTERS OF ENDORSEMENT. ANY COMMAND AT RISK OF NOTRETURNING ITS ENDORSEMENT TO THE MARINE WITH A SUFFICIENTCUSHION PRIOR TO THE APPLICATION DEADLINE SHOULD IMMEDIATELYNOTIFY THE MCRC ON-E POC.

APPLICATIONS RECEIVED WITHOUT ALL ENDORSEMENTS WILL NOT BE CONSIDERED BY THE BOARD.

IF THE SENIOR ENDORSER DEEMS THE MARINE "NOT RECOMMENDED" FOR APPOINTMENT, THE MARINE IS INELIGIBLE FOR BOARD CONSIDERATION.

COMMANDING OFFICERS ARE DIRECTED TO PASS THIS INFORMATION TO ELIGIBLE MARINES IN THEIR COMMAND, REVIEW APPLICATIONS FOR COMPLETENESS, ENSURE THAT MARINES REQUESTING WAIVERS RECEIVE COMPREHENSIVE JUSTIFICATION ON ALL ENDORSEMENTS (INCLUDING THE SENIOR ENDORSER), AND MAKE DEFINITIVE RECOMMENDATIONS REGARDING ALL MARINES WHO SUBMIT APPLICATIONS.

COMMANDING OFFICERS MUST SPECIFICALLY ADDRESS THE TECHNICAL PROFICIENCY OF THE MARINE IN EACH MOS FOR WHICH THEY ARE APPLYING. ENDORSEMENTS AND APPLICATIONS MUST BE SCREENED CLOSELY TO ENSURE THAT ONLY TECHNICALLY AND PROFESSIONALLY QUALIFIED MARINES ARE SUBMITTED FOR CONSIDERATION.

SSIC Date

FIRST ENDORSEMENT on Sergeant John J. Doe 000 00 0000/0000 USMC application (originating code and date)

From: Commanding Officer To: Commandant of the Marine Corps

Via: (1) Endorsing Chain of Command (2) Commanding General, Marine Corps Recruiting Command (ON/E), 3280

Russell Road, Quantico, VA 22134

Subj: REQUEST FOR APPOINTMENT UNDER THE FISCAL YEAR 20XX ENLISTED TO WARRANT OFFICER (GUNNER) PROGRAM

1. The information contained in the basic application and the enclosures hasbeen verified with the records on file at this command and are correct. The applicant meets the basic eligibility requirements for the Fiscal Year 20XX Enlisted to Warrant Officer (Gunner) Program.

2. The height and weight of the applicant is inches and pounds. Body fat _____% (if applicable). The applicant last took the PFT on (date) and obtained the following score:

Pull ups/Flex Arm Hang 23 (100) Crunches 115 (100) Run time 18:00 (100) Total (300)

The applicant last took the CFT on (date) and obtained the following score:

Movement to Contact 2:38 (100) Ammo Lift 116 (100) Maneuver under Fire 2:04 (100) Total (300)

3. "I have viewed the applicant's tattoos or brands (photos and/ordescription) attached as enclosure (xx) and they are within the Marine Corps standards per the Marine Corps Uniform Regulations." (Omit this paragraph if it does not apply.)

4. Any recommendation must be fully justified by the commandingofficer and must include one of the following recommendation categories:

a. Recommended with enthusiasm.

b. Recommended with confidence.

Commander's comments in the supporting justification will specificallyaddress the technical proficiency of the applicant in the MOS for which applying, and where possible, cite the accomplishments of the Marine in that field.

5. In addition to the recommendation, any waiver requested must befully justified by the commanding officer. (Omit this paragraph if it does not apply.)

6. If the endorsement is "Not recommended" or is otherwise derogatoryor unfavorable, this paragraph must read: "The applicant has been counseled as to the nature and content of the endorsement per reference (__). The applicant has been given an opportunity to make a statement." Reference (__) provides further guidance. (Omit this paragraph if it does not apply.)

SIGNATURE OF COMMANDING OFFICER

c. Recommended with reservation.

d. Not recommended.

________ ________

FIRST ENDORSEMENT on ____________________________ ______________/_______ USMC application __________________________

From: Commanding Officer, ________________________________________________ To: Commandant of the Marine Corps

Via: ____________________________________________________________________ ____________________________________________________________________ ____________________________________________________________________ ____________________________________________________________________ ____________________________________________________________________ ____________________________________________________________________

Subj: REQUEST FOR APPOINTMENT UNDER THE FISCAL YEAR 20___ ENLISTED TO WARRANT OFFICER (GUNNER) PROGRAM

1. The information contained in the basic application and the enclosures hasbeen verified with the records on file at this command and are correct. The applicant meets the basic eligibility requirements for the Fiscal Year 20___ Enlisted to Warrant Officer (Gunner) Program.

2. The height and weight of the applicant is inches and pounds. Body fat is ______%. The applicant last took the PFT on ______________ and obtained the following score:

Pull ups/Push ups ____ (____) Crunches ____ (____) Run timeTotal

___:____ ( ) (____)

The applicant last took the CFT on ______________ and obtained the following score:

3. __________________________________________________________________________________________________________________________________________________ ___________________________________________________________________________

4. _______________________________________________. _______________________________________________________________________________________________________________________________________________________________________________

Movement to Contact ____ (____) ____ (____) Ammo Lift

Maneuver under FireTotal

___:____ ( ) (____)

________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

5. _______________________________________________________________________

____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________

________________________________

SSIC CODE DATE

From: Grade, Full Name, EDIPI, MOS, and USMC To: Commandant of the Marine Corps (MORE) Via: Immediate commanding officer and endorsing chain of command

Subj: REQUEST FOR APPOINTMENT UNDER THE FISCAL YEAR (XX) WARRANT OFFICER PROGRAM (GUNNER)

Ref: (a) SECNAVINST 1412.9B (b) MCO 1040.42A (c) Announcement MARADMIN

Encl: (1) Data Sheet (2) Photograph (3) Essay (4) Certified MCTFS Screens (BIR/BTR, Education, Awards, Chronological Order, Test) (5) Test Scores (if qualifying with ACT/SAT) (6) NAVMC (11) with Fraternization Statement (7) Security Clearance Verification Letter(8) NJP and Statement (if applicable)(9) Tattoo Screening Form/Tattoo Statement of Understanding (10) Tattoo Photos and Page 11 (if applicable)(11) Letters of Recommendation (if applicable) (12) Letters to the Board President (if applicable)(13) Professional Cerrtificates (if applicable)(14) College Transcripts (if applicable)(15) Medical Submission (DD 2808 and 2807 and as applicable)

1. I am eligible and apply for the Fiscal Year (XX) Warrant OfficerProgram (Gunner) as outlined in references (a) and (m). Enclosures (1) through (15) (as applicable) are attached as requested. The following information is submitted:

a. I require a waiver for the following: N/A or list waivers.

b. “I, (Full Name), if selected for appointment to WO and uponacceptance of such appointment, agree to remain on active duty for a period of not less than 3 years, unless sooner separated for cause under the provisions of SECNAVINST 1920.6C, Administrative Separation of Officers. I understand that this obligation will run concurrently with any other legal obligation in force and will not serve to decrease any such obligation.”

e. List off-duty education courses if not included in MCTFS education

f. List military schools and correspondence courses completed if notincluded in the MCTFS education screen. (Include school now attending and/or correspondence course (s) currently enrolled in, if applicable)

c.

d.

Date of Birth: YYYYMMDD.

Permanent grade and Date of Rank.

screen. (Attach transcripts, if applicable)

Subj: REQUEST FOR APPOINTMENT UNDER THE FISCAL YEAR (XX) WARRANT OFFICER PROGRAM (GUNNER)

g. I have a NAC/Background Investigation (BI)/Special BackgroundInvestigation (SBI) completed by the Defense Investigative Service on (date); or I do not have a NAC/BI/SBI, but I initiated one on (date). Enclosure (8) applies (if applicable).

h. Active naval service as of (date of appointment): XX yrs XX mosXX days. If other than naval service is included in your Armed Forces Active Duty Base Date (AFADBD), include branch of service, periods of service and highest grade held.

k. MOS for which applying (as appropriate):

(1) First Choice:(2) Second Choice:(3) “I am/am not willing to accept any MOS in which the board

considers me qualified.”

i. "No UPB is provided due to no record of disciplinary action." ORProvide NJP and statement addressing 5 W's as separate enclosures.

j. Recent photo per reference (c) is attached as enclosure (___).

m. List years of actual experience and key billets held in firstand second choice MOSs (if applicable).

n. Unit and applicant telephone number and point of contact.(Indicate your admin office’s DSN or commercial numbers only. DO NOT use FTS numbers.)

_______________________ Signature of applicant

l. List test(ACT/SAT/ASVAB), test score, and date tested.

_______ _______ _______

From: __________________________________________________________________ To: Commandant of the Marine Corps Via: __________________________________________________________________

__________________________________________________________________ __________________________________________________________________ __________________________________________________________________

__________________________________________________________________

Subj: REQUEST FOR APPOINTMENT UNDER THE FISCAL YEAR _____ WARRANT OFFICERPROGRAM (GUNNER)

Ref: _________________________________ _________________________________ _________________________________ _________________________________ _________________________________ _________________________________ _________________________________ _________________________________ _________________________________ _________________________________ _________________________________ __________________________________________________________________

Encl: __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________

1. I am eligible and apply for the Fiscal Year _____ Enlisted to WarrantOfficer (Gunner) Program as outlined in references (a) through (m). Enclosures (___) through (___) are attached as requested. The following information is submitted:

a. I require a waiver for the following: _____________________________________________________________________________________________________________________________________________________________________________________

Subj: REQUEST FOR APPOINTMENT UNDER THE FISCAL YEAR ______ WARRANT OFFICER PROGRAM (GUNNER)

e. List off duty education courses: _________________________________

f. List military schools and correspondence courses completed (includeschools now attending and/or correspondence course(s) currently enrolled in, if applicable): ___________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ________________________________________________________________________________________________________________________________________________________

g. ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

h. Active naval service as of _______________________: _________________________________________________________________________________________________________________________________________________________________________

j. Recent photo per reference (m) is attached as enclosure (____).

k. MOS for which applying (as appropriate):

(1) First Choice: _____________(2) Second Choice: _____________(3) “I _______ willing to accept any MOS in which the board considers

me qualified.”

l. _________ test score and date tested: ______ _________________________________________________________________________________________________________________________________________________________________________

____________________________________________________________________________ ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

i.________________________________________________________________________________________________________________________________________________________

c. Date of Birth: ___________.

d. Permanent grade and Date of Rank: _____, ________________.

____________________________________________________________________

b. “I, _________________________, if selected for appointment to WOand upon acceptance of such appointment, agree to remain on active duty for a period of not less than 3 years, unless sooner separated for cause under the provisions of SECNAVINST 1920.6C, Administrative Separation of Officers. I understand that this obligation will run concurrently with any other legal obligation in force and will not serve to decrease any such obligation.”

Position/Years: ___________________________________________________________ Job Description: _____________________________________________________________________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________

Position/Years: ___________________________________________________________ Job Description: __________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________





Position/Years: ___________________________________________________________ Job Description: __________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________

m. List years of actual experience and key billets held in firstand second choice MOSs (if applicable).Position/Years: ___________________________________________________________Job Description: ______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

n. The Unit Point of Contact is __________________________________ at________________ or via email at _______________________________. I can be reached at _________________ or via email at ____________________________.

_____________________

Position/Years: ___________________________________________________________ Job Description: __________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ______________________________________________________________________________________________________________________________________________________


Position/Years: ___________________________________________________________ Job Description: __________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ______________________________________________________________________________________________________________________________________________________

DATA SHEET FOR WARRANT OFFICER GUNNER PROGRAM

COLUMN 1 COLUMN 2

____________________________

____________________________

____________________________

____________________________

____________________________

____________________________

____________________________

____________________________

____________________________

____________________________

____________________________

___ Y / ___ N

A. LAST NAME

B. FIRST NAME

C. MIDDLE INITIAL

D. SSN

E. PRESENT PAY GRADE

F. PRESENT MOS

G. FIRST CHOICE MOS FOR WHICH APPLYING

H. RACE/ETHNIC CODE (PER BIR)

I. AGE (AS OF 1 FEB ___)

J. TOTAL NAVAL SERVICE (AS OF 1 FEB ___)

K. GT TEST SCORE (Ci rcl e one) :

L. ESSAY INCLUDED

===============HQMC==============ACTION================ONLY============ WO(RES) PROGRAM

CHECKLIST WAIVERS REQUIRED TATTOO PHOTOS PHOTOGRAPH SRB PAGES (12,11,9,3) ROS (SGTS ONLY) EDU

BIR/BTR ENDORSEMENTS

US CITIZEN RECOMMENDED ANS 16 – 23 NOT RECOMMENDED GT > 110 NAC MCC ______ RUC _______

____________________________________________________________________________________________________________________________________

PROMOTION PHOTO

REQUIRED FOR ALL APPLICANTS:

• THE BELOW PERTAINS TO PROMOTION TYPE PHOTO

• MUST BE WITHIN 1 YEAR OF BOARD DATE APPLYING

• MUST BE SUBMITTED TO MMRP FOR INCLUSION IN OMPF FOR ALLAPPLICANTS

MARINES ARE RESPONSIBLE FOR VERIFYING RECEIPT OF PHOTO BY MMRP. THE PRIMARY, MOST EXPEDITIOUS METHOD TO CONFIRM RECEIPT IS THROUGH OMPF VIA MOL.

PHOTOS WILL BE AVAILABLE FOR VIEWING ON OMPF ONLINE WITHIN 24 HOURS OF PHOTO RECEIPT BY MMRP. THE DATE OF THE PHOTOGRAPH, AS NOTED ON THE PHOTOGRAPH TITLE BOARD, IS CONSIDERED THE PRIMARY DATE OF DETERMINING THE 12 MONTH PHOTOGRAPH ELIGIBILITY WINDOW FOR SELECTION BOARDS. MARINES ARE ADVISED THAT ALTHOUGH A PHOTO MAY BE OVER 12 MONTHS OLD, THE PHOTO WILL REMAIN IN THE OMPF UNTIL AN UPDATED PHOTO IS SUBMITTED.

IF A DIGITAL PHOTO HAS BEEN SENT TO MMRP, THE FOLLOWING STATEMENT MUST BE INCLUDED IN THE APPLICATION: "A DIGITAL PHOTO HAS BEEN SENT TO MMRP WITHIN THE PAST 12 MONTHS." A PHOTOGRAPH IS ALSO REQUIRED AS AN ENCLOSURE TO THE APPLICATION FOR MCRC SCREENING PURPOSES.

ESSAY

REQUIRED:

• ESSAY MUST BE 200-400 WORDS AND MUST ADDRESS THE FOLLOWINGSUBJECTS:

(1) THE MOST COMPELLING REASON I DESIRE TO BECOME A CWO (MARINE GUNNER) IN THE USMC.

(2) WHAT I FEEL MY DUTIES WILL ENTAIL ON A DAILY BASIS

(3) HOW I INTEND TO MAKE THE TRANSFORMATION TO A WARRANT OFFICER

CERTIFIED MCTFS SCREENS

REQUIRED:

• BIR/BTR• CHRONOLOGICAL ORDER• AWARDS• EDUCATION

SUBMIT APPROPRIATE CERTIFIED MARINE CORPS TOTAL FORCE SYSTEM (MCTFS) SCREENS. MARINES MUST ENSURE SRB PAGES THAT HAVE BEEN REMOVED AND REPLACED BY MCTFS ARE UPDATED, AND MADE A PART OF THEIR APPLICATION.

• TEST SCORE SCREEN

APTITUDE TEST SCORES

PROVIDE ONE OF THE FOLLOWING:

• OFFICIAL SAT SCORE REPORT - 1000 SAT MINIMUM (MATH ANDCRITICAL READING ONLY)

• OFFICIAL ACT COLLEGE REPORT – COMBINED ENGLISH AND MATHSCORE OF 39 OR A COMPOSITE SCORE OF 22

• MINIMUM GENERAL TECHNICAL (GT) COMPOSITE SCORE OF 110 DERIVED FROM THE ARMED SERVICES VOCATIONAL APTITUDE BATTERY (ASVAB) OR THE ARMED FORCES CLASSIFICATION TEST (AFCT)NOTE: GT SCORE IS NOT WAIVERABLE.

MARINES MEETING THE APTITUDE TEST SCORE REQUIREMENT WITH AN ACT OR SAT TEST SCORE MUST INCLUDE A CERTIFIED COPY OF THE TEST REPORT WITH THE APPLICATION.

MARINES MEETING THE APTITUDE TEST SCORE REQUIREMENT WITH AN ASVAB MUST USE THE MCTFS TEST SCORE SCREEN (TEST) AS EVIDENCE OF A QUALIFYING GT SCORE.

ONLY GT SCORES RESIDENT WITHIN MCTFS WILL BE ACCEPTED AS OFFICIAL SCORES OF RECORD FOR ALL MARINES.

_______________________ SNM

_____ I have read and understand the Marine Corps Policy on fraternization, as a commissioned or warrant officer. I will be required to conduct myself as an officer with respect to all enlisted personnel, of any service, at all times. Specifically, I understand that I may have to make significant changes in my current personal relationships with other service members if I become an officer. I also understand that fraternization is an offense under the UCMJ, and that the prohibition of fraternization does not make an exception for preexisting relationships other than marriages, that took place prior to my date of commission or appointment to warrant officer or other family rlationships, such as between parents and children or between siblings.

1040 Code Date

From: Security Officer, Unit Name To: Commanding General, Marine Corps Recruiting Command

Subj: SECURITY CLEARANCE VERIFICATION LETTER

1. The following information has been extracted from officialrecord:

a. Name: Marine Full Name/EDIPI/PMOS

b. Clearance: Investigation – PRSC (YYYYMMDD) OPMNACLC (YYYYMMDD) OPM ENAC (YYYYMMDD) OPM

Eligibility – SECRET (YYYYMMDD) DoNCAF

U.S. Access - Secret

2. Add sentence here if eligibility has expired and newinvestigation has been opened and provide date investigation was opened and accepted. (Note: Secret is good for 10 years and Top Secret is good for 5 years)

3. Point of contact for this matter is (Rank Full Name), defensesystem network (DSN) or commercial telephone numbers, and electronic mail address (EMAIL).

SECURITY OFFICER SIGNATURE

1040 ______ ______

From: _________________________, __________________________ To: Commanding General, Marine Corps Recruiting Command

Subj: SECURITY CLEARANCE VERIFICATION LETTER

1. The following information has been extracted from officialrecord:

a. Name: ______________________________________________

b. Clearance: Investigation – PRSC (__________) OPMNACLC (__________) OPM ENAC (__________) OPM

Eligibility – ___________ (__________) DoNCAF

U.S. Access - ___________

2. ______________________________________________________________________________________________________________________________________________________________________________________________.

3. Point of contact for this matter is ________________________,_____________________, and _____________________________________.

__________________________

REQUIRED TATTOO DOCUMENTS

• TATTOO SCREENING FORM

o ENSURE ALL REQUIRED SIGNATURES AND CERTIFICATIONS AREFILLED OUT

o IF YES TO TATTOOS ENSURE BODY LOCATIONS ARE DOCUMENTEDON PAGE 3

• TATTOO STATEMENT OF UNDERSTANDING

ALL TATTOO(S) MUST HAVE WRITTEN DESCRIPTION

IF MARINE IS IN THE PROCESS OF HAVING TATTOOS REMOVED, THE FOLLOWING IS REQUIRED:

1. PHOTOS OF TATTOOS BEFORE START OF REMOVAL PROCESS WITH DESCRIPTION

2. PHOTOS OF TATTOOS AFTER EACH REMOVAL TREATMENT/ APPOINTMENT

3. STATEMENT FROM PROVIDER DETAILING NUMBER OF PROCEDURES, NUMBER OF PROCEDURES REMAINING, AND THE ANTICIPATED DATE REMOVAL PROCESS WILL BE COMPLETE.

PART VI CAN BE LEFT BLANK.

USMC OFFICER TATTOO SCREENING FORMInsert into MCRCO 1100.2A, Appendix O, Updated by MCRC FROST CALL 017-16

1

NAME_________________________________ L4 SSN_________________ DATE_____________

Part I: Purpose. The purpose of this form is to ensure that you disclose the full extent of your tattoos, brands and/or body ornamentation. Refusal to complete the form will result in termination of your enlistment processing.

1. Does the applicant currently have, or ever had any tattoos, brands, bodymarkings, or body ornamentation, or has the applicant ever had a tattoo, brand or body ornamentation removed, concealed, covered or altered? (Initials in appropriate block)

Y _____ N_____

Notes: If the answer to Question 1 is NO; move to Part II Certification Block of this Screening Form. Questions 2 through 9 are not required. If the answer to Question 1 is YES; complete Questions 2-9, then certify in Part II and forward for Review.

2. Does applicant have body markings of any type that are exposed or partiallyexposed while wearing the standard warm weather PT uniform (shorts & shirt)?

Y_____ N_____ 3. Are any of the tattoos, brands or markings:

- on head or neck (above collarbone in front, above seventh [C7] cervical [last] vertebrae in back or otherwise visible in open collar short sleeve khaki shirt with white undershirt) or inside the mouth?

- on hands, elbows, knees, or fingers (with exception of wedding band tattoo–not to exceed 3/8 of an inch), or within 2 inches of the wrists?

Y ____ N_____

4. Are any tattoos, markings or ornamentations exposed while wearing the standardPT uniform:

- Larger than the individual wearers hand with fingers extended and joined? - Band Tattoos, (cannot exceed 3 inches or the width of the individual’s four

fingers extended and joined, whichever is greater)? - Single band tattoo on one finger (max width less than 3/8 of an inch)? - Excessive Tattoos (combined coverage must be covered by the individual

wearers hand with their fingers extended and joined)? Y _____N_____

5. Do any of the tattoos, markings etc., depict nudity, are they racist,eccentric, offensive in nature, or express an association with conduct or substances prohibited by the Marine Corps Drug policy, the UCMJ, to include tattoos associated with illegal drugs, drug usage or paraphernalia?

Y _____N_____

6. Do any of the tattoos, brands or body ornamentation represent a gang membershipor extremist group, advocate racial, ethnic, or religious discrimination, obscene, prejudicial to good order and discipline/morale or of a nature to discredit to the Marine Corps?

Y______N______

7. Are any of the tattoos a result of a specific activity? (i.e. activity formembership initiation, or as the result of any violation of law(s))?

Y _____N______


2

NAME_________________________________ L4 SSN_________________ DATE_____________

8. Are there any body markings, ornamentation or mutilation (i.e. Tongue Splitting,etc), Ornamental Body Piercing(s), Holes in Ear Lobes (large enough for light to pass through opening), or Ornamental Implantations, (silicone implants on face, horns on the forehead, etc).

Y______ N_____

Location(s) of an applicant’s current, removed, concealed, covered, or altered tattoos, brands, markings, or ornamentation will be documented in Part IV of this Screening Form. Removed, concealed, covered or altered tattoos need to be annotated as such (i.e. removed) with full description of the original marking.

Part II: Certification. I have completely disclosed the full extent of my tattoos, brands or body ornamentation to include those removed or altered.

_________________________________ ________________________________ _______ (Name of Candidate) (Signature) (Date)

“Applicant qualified in accordance with MCBul 1020 & Frost Call 017-16.”

_________________________________ ________________________________ ________ (Name of Certifying Officer) (Signature) (Date)

*Certifying Officer Comments:___________________________________________________________________________________

___________________________________________________________________________________________________

* A Certifying Officer is a commissioned officer at the Recruiting Station, NROTCUnit, USNA, or in the chain of command for enlisted Marines applying for a Commissioning of Warrant officer Programs.

Part III: Reviewing.

a. If the applicant responded “Yes” to question 2, the tattoo must be reviewedto determine eligibility. If the applicant responded “Yes” to questions 3-8, the applicant is ineligible (with the exception to the wedding band tattoo authorized on one finger) for commission.

b. Digital photos are required for all reviews. Photos not required of femaleapplicants with torso tattoos or male applicants with lower torso (below waist) tattoos. Applicants may hand draw pictures of torso & lower torso tattoos indicating size and location. Cross-check drawings with DD Form 2808 Medical Examination, Block 37 documents for consistency. Under no circumstances will a female applicant be photographed in less clothing than the standard warm weather physical training uniform.

c. All questionable body markings in regards to content, size, number orlocation will be forwarded to the appropriate authority for approval/review. Check appropriate review authority:

[ ] Recruiting Districts. Review tattoos for applicants applying for the Platoon Leaders Class, Officer Candidate Course, and Four Year Naval Reserve Officer Training Scholarship programs.

USMC OFFICER TATTOO SCREENING FORM Insert into MCRCO 1100.2A, Appendix O, Updated by MCRC FROST CALL 017-16

3

NAME_________________________________ L4 SSN_________________ DATE_____________

[ ] Marine Corps Recruiting Command. Review tattoos for applicants applying to all other commissioning and Warrant Officer programs.

“Applicant is eligible for commissioning after review and adjudication in accordance with MCBul 1020 & Frost Call 017-16.”

_____________________________________________________________________________ NAME/SIGNATURE OF REVIEWING OFFICER RANK BILLET

Part IV. Documentation. The following depicts the location and description of the applicant’s Body Markings. Place number on body location and describe in blocks below indicating content and size in inches:

FRONT VIEW BACK VIEW

1. ___________________________________ 1. __________________________________

2. ___________________________________ 2. __________________________________

3. ___________________________________ 3. __________________________________

4. ___________________________________ 4. __________________________________

5. ___________________________________ 5. __________________________________

6. ___________________________________ 6. __________________________________


4

NAME_________________________________L4 SSN_________________DATE_____________

Part V. Certification. I certify above body marking information is accurate.

________________________________ ____________________________________ ____________ (Name of Candidate) (Signature) (Date)

“Applicant qualified in accordance with MCBul 1020 & Frost Call 017-16.”

_______________________________ ____________________________________ ____________ (Name of Certifying Officer) (Signature) (Date)

Part VI. Recertification. (Prior to Request for Appointment) I certify the information previously given on Tattoo Screening Form remains the same. If any change is indicated an addendum Tattoo Screening Form will be complete then forwarded to the appropriate authority prior to the Request for Appointment.

1. Changes to this Tattoo Screening Form Y______ N _____

_________________________________ _______________________________ __________ (Name of Candidate) (Signature) (Date)

“Applicant is eligible for commissioning after review and adjudication in accordance with MCBul 1020 & Frost Call 017-16.”

_____________________________________________________________________________ NAME/SIGNATURE OF REVIEWING OFFICER RANK BILLET

OFFICER CANDIDATE STATEMENT OF UNDERSTANDING APPENDIX P

1. Purpose. The purpose of this Statement of Understanding (SOU) is to ensure youunderstand the Marine Corps policy concerning Tattoos, Branding and Ornamentation, contained in MCBul 1020 and USMC Uniform Board Regulation MCO P1020.34G.

2. Policy. Marine Corps policies strictly PROHIBIT any tattoos, brandings, mutilations,or ornamentations on the head (including in or around the mouth), neck area, hands, fingers, elbows, knees, and within two inches of the wrist. Any tattoos, brandings, mutilations, or ornamentation on other parts of the body, that are prejudicial to good order and discipline, gang or extremist group related, or bring discredit to the Marine Corps are also PROHIBITED. Descriptions:

a. Prejudicial to Good Order and Discipline. Tattoos, brands or ornamentation thatare drug-related, gang-related, extremist, obscene or indecent, sexist (express nudity), or racist, excessive (sleeve tattoos), eccentric, offensive in nature, or express an association with conduct or substances prohibited by the Marine Corps drug policy.

b. Gang or Extremist Group. Any tattoos, brands or ornamentation that areaffiliated with, depicting, or symbolizing extremist philosophies, organizations, or activities. Extremist philosophies, organizations, and activities are those which advocate racial, gender, or ethnic hatred or intolerance; advocate, create or engage in illegal discrimination based on race, color, gender, ethnicity, religion, or national origin; or advocate violence or other unlawful means of depriving individual rights under the U.S. Constitution and federal or state law.

c. Size. Any tattoos exposed when wearing the properly fitting standard warmweather physical training gear (T-Shirt & shorts), must be covered by the individuals hand with their fingers extended and joined with the thumb flush against the side of the hand.

d. Location. Tattoos on the head (including in or around the mouth), neck area,hands, fingers (with exception of one single band tattoo on one finger only), elbows, knees, and within two inches of the wrists are prohibited. The head is defines as the portion of the body above the first cervical vertebrae (C1). The neck is defined as the portion of the body above the collarbone in the front area, above the seventh cervical vertebrae (C7) in the back area, and visible while wearing the properly fitting warm weather physical training shirt. Tattoos on the chest or back that cannot be covered by wearing a crew neck t-shirt in the Service C uniform or utility uniform are prohibited. Tattoos on the elbow or knees are also prohibited. These areas must be free of tattoos and separates any tattoos on the upper arm/upper leg from any tattoos on the lower arm/lower leg.

e. Ornamentation. Defined as any mutilation to the body such as tongue splitting,body piercing(s), holes in ear lobes (large enough for light to pass through), or implantations, such as silicone implants on face, horns on the forehead, etc. All applicants must remove body ornamentation (i.e. body piercings) while participating in any/all pool functions and prior to shipping.

3. Certification. I certify that I completely understand the Marine Corps policy on thetattoos, brands, and ornamentations. I understand that I will be screened for tattoos, brands and body ornamentations, and must complete the Marine Corps Tattoo Screening Form. I further understand I will be re-screened prior to my request for appointment, for any additional tattoos, brands and body ornamentations received while in the officer commissioning process. Prohibited body markings received while in pool are disqualifying.

__________________________ _______________________ ____________ (Applicant’s Printed Name) (Applicant’s Signature) (Date)

__________________________ _______________________ ____________ (Name of Certifying Officer) (Signature of Certifying Officer) (Date)

WAIVERS

• NONJUDICIAL PUNISHMENTS (NJP)

o NJPS MUST BE ADDRESSED IN THE APPLICATION WITH A SIGNED, DETAILED STATEMENT, ADDRESSING THE 5 WS EXPLAINING THE CIRCUMSTANCES. STATEMENTS MUST BE INCLUDED IN THE APPLICATION AS A SEPARATE ENCLOSURE.

• OTHER WAIVERS

o REQUESTS FOR A WAIVER OF THE ELIGIBILITY REQUIREMENTSAND EXCEPTION TO POLICY, EXCEPT THOSE ESTABLISHED ASUNWAIVERABLE BY LAW OR SPECIFIED AS UNWAIVERABLE BYTHE MARADMIN, MAY BE CONSIDERED ON A CASE-BY-CASEBASIS BY THE CG, MCRC.

o REQUESTS FOR WAIVER OF DISCIPLINARY ACTION REQUIREMENTSMUST INCLUDE APPROPRIATE JUSTIFICATION.

TATTOO DOCUMENTATION

• TATTOO PHOTOS

• REQUIRED IF APPLICANT HAS EVER OR CURRENTLY HAS ANYTATTOOS, BRANDS, BODY MARKINGS, OR BODY ORNAMENTATION

• MUST PROVIDE FULL BODY PHOTOS IN GREEN PT GEAR (ALL 4ANGLES)

• MUST PROVIDE CLOSE UP COLOR PHOTOS FOR EACH TATTOO (IFNOT VISIBLE IN PT GEAR, INCLUDE HAND DRAWN COLOR IMAGE)

ALL TATTOO(S) MUST HAVE WRITTEN DESCRIPTION

IF TATTOOS OR MARKINGS CANNOT BE EASILY DETERMINED TO BE WITHIN STANDARDS, PROVIDE MEASUREMENT PHOTOS TO VERIFY THAT TATTOOS ARE WITHIN POLICY AS PER MCBUL 1020. UTILIZE THE TATTOO MEASURING TOOL FROM THE MCBUL OR A RULER.

• TATTOO PAGE 11

• REQUIRED IF APPLICANT HAS HAD ANY TATTOO, BRANDS,BODY MARKINGS OR BODY ORNAMENTATION DOCUMENTED ON ANAVMC 118 (11).

GUIDANCE FOR COLOR PHOTOS

REQUIRED IF APPLICANT HAS EVER OR CURRENTLY HAS ANY TATTOOS, BRANDS, BODY MARKINGS, OR BODY ORNAMENTATION:

• TATTOO PHOTOS

• MUST PROVIDE CLOSE UP COLOR PHOTOS FOR EACH TATTOO (IF NOTVISIBLE IN PT GEAR FOR FEMALES/SHORTS FOR MALES, INCLUDE HAND DRAWN COLOR IMAGE)

ALL TATTOO(S) MUST HAVE WRITTEN DESCRIPTION TO INCLUDE THE FOLLOWING: LOCATION, SIZE, DATE RECEIVED, AND MEANING OF TATTOO (IF ANY).

IF TATTOOS OR MARKINGS CANNOT BE EASILY DETERMINED TO BE WITHIN STANDARDS, PROVIDE MEASUREMENT PHOTOS TO VERIFY THAT TATTOOS ARE WITHIN POLICY AS PER MCBUL 1020. UTILIZE THE TATTOO MEASURING TOOL IN THE MCBUL 1020. NOTE: THERE IS NO GRANDFATHERING AS IT PERTAINS TO WARRANT OFFICER OR COMMISSIONING PROGRAMS, THEREFORE YOU MUST MEET ALL STANDARDS OF THE MCBUL.

• MUST PROVIDE FULL BODY PHOTOS IN GREEN PT GEAR (ALL 4ANGLES - FRONT, RIGHT, REAR, LEFT)

IF COMPLETING ELECTRONICALLY, COPY AND PASTE PHOTOS AND RESIZE TO FIT INTO APPROPRIATE PHOTO BOXES.

ALL PHOTOS MUST BE HIGH QUALITY AND SHOW LOCATION IN REFERENCE TO DISTANCE FROM ELBOW, KNEE, WRIST, ETC.

ALL PHOTOS MUST BE IN THE FORM BELOW OR TAKEN AT COMBAT CAMERA.

IF HAND-DRAWN, DRAWINGS MUST BE DETAILED AND ACCURATELY REPRESENT THE TATTOO.

TATTOO PHOTOS INSERT YOUR PHOTOS BY CLICKINGIN THE SQUARE PROVIDED AND SELECT THE APPROPRIATE PHOTO.

PTGEAR PHOTOS (GREEN ON GREEN PT GEAR ONLY)

I RANK I I NAME I IEDIPll

LEFT PROFILE RIGHT PROFILE

FRONT PROFILE REAR PROFILE

I RANK I I NAME I I EDIPll

TATIOO NUMBER ONE TATIOO NUMBER TWO

SIZE: SIZE:

DESCRIPTION: DESCRIPTION:

LOCATION: LOCATION:

MEANING: MEANING:

TATIOO NUMBER THREE TATIOO NUMBER FOUR

SIZE: SIZE:


LOCATION: LOCATION:

MEANING: MEANING:

I RANK I I NAME I I EDIPll

TATIOO NUMBER FIVE TATIOO NUMBER SIX

SIZE: SIZE:


LOCATION: LOCATION:

MEANING: MEANING:

TATIOO NUMBER SEVEN TATIOO NUMBER EIGHT

SIZE: SIZE:


LOCATION: LOCATION:

MEANING: MEANING:

I RANK I I NAME ' I EDIPll

TATIOO NUMBER NINE TATIOO NUMBER TEN

SIZE: SIZE:


LOCATION: LOCATION:

MEANING: MEANING:

TATIOO NUMBER ELEVEN TATIOO NUMBER lWELVE

SIZE: SIZE:


LOCATION: LOCATION:

MEANING: MEANING:

PROOF OF US CITIZENSHIP

REQUIRED OF DUAL OR NATURALIZED CITIZENS:

• SUBMIT A CERTIFIED COPY OF ONE OF THE FOLLOWING:

o FOREIGN BIRTH CERTIFICATE TRANSLATED IN ENGLISH(LANGUAGE DEPARTMENT AT A COLLEGE OR UNIVERSITY ISAUTHORIZED TO VERIFY)

o FORM N-560/N-561 CERTIFICATE OF CITIZENSHIPo FORM N-550/N-551 CERTIFICATE OF NATURALIZATIONo DS FORM 1350 CERTIFICATION OF BIRTHo FS FORM 545 CERTIFICATION OF BIRTH ABROADo FS FORM 240 REPORT OF BIRTH ABROAD OF CITIZENS OF THE

USo US PASSPORT

IF APPLICANT IS FOREIGN BORN OF US CITIZEN PARENTS, APPLICANT MUST PROVIDE ONE (1) PARENT’S BIRTH CERTIFICATE WITH FS FORMS 240 AND FS FORM 545

MEDICAL DOCUMENTS

REQUIRED:

• DATED REPORT OF MEDICAL EXAMINATION (DD FORM 2808)

• DATED REPORT OF MEDICAL HISTORY (DD FORM 2807-1)

• ALL SUPPORTING MEDICAL DOCUMENTS

o DENTAL EXAM MUST BE WITHIN 1 YEAR. DENTAL CLASS MUST BE TYPE 1 OR2 AND DOCUMENTED BY A DENTIST ON THE DD FORM 2808 AND AS A SEPARATE ENCLOSURE

o HIV RESULTS MUST BE WITHIN 2 YEARS. DATE TESTED AND ROSTER NUMBERMUST BE DOCUMENTED ON THE DD FORM 2808 AND AS A SEPARATE ENCLOSURE

o RESULTS OF AN UPDATED AUDIOGRAM MUST BE DOCUMENTED ON THE DD FORM2808 AND/OR A SEPARATE ENCLOSURE

o ALL SUPPORTING DOCUMENTS FOR ANY SURGURIES TO INCLUDE PRE AND POSTOPERATIVE PAPERWORK

o YES ANSWERS ON DD FORM 2807 MUST BE EXPLAINED BY A PHYSICIAN INBLOCK 25 AND SUPPORTING DOCUMENTS ATTACHED. ALL ANSWERS ON THE DD FORM 2808 MUST BE MARKED NORMAL OR ABNORMAL. “NE” SHOULD BE MARKED FOR QUESTION 41 FOR MALES ONLY.

REFER TO CURRENT MARADMIN FOR MEDICAL REQUIREMENTS AND GUIDANCE.

COMMISSIONING PHYSICALS (DD FORMS 2808 AND 2807) ARE GOOD FOR TWENTY FOUR (24) MONTHS TO DATE OF APPOINTMENT AS LONG AS ANNUAL REQUIREMENTS ARE CURRENT: EITHER AN ANNUAL CERTIFICATION OF PHYSICAL CONDITION OR PHYSICAL HEALTH ASSESSMENT (PHA). COMMISSIONING PHYSICALS MUST BE COMPLETED BY A MILITARY DOCTOR.

POC FOR ALL MEDICAL QUESTIONS CAN BE REACHED AT (703)784-9427.

warrant officer (gunner) application

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