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Personnel Information Form



Email

Email:  

Public Affairs Information

Submitting Unit:

Basic Information

Branch/Rank:
First Name:
Last Name:
Your Email Address:
Your Phone Number:
MOS (in words):
Military Specialty?
Unit:
Component:
Years of Service:
Awards:
If Reserve or Guard, what is your civilian job?
 

Personal Information

Race/Ethnic Origin:
Gender:
Language(s) you speak fluently:
Religion:
High School/University:
 

Deployment Information

Current Location:
Home Station:
When were you deployed?
When do you redeploy?
Number of times deployed to this area?
(select country, state if applicable, and city)
Hometown Country:
Hometown State:
Hometown City:
 

Family Information

Family Contact
City, State:
Phone Number:
Relationship:
May media contact this family member?
Family Contact:
City, State:
Phone Number:
Relationship:
May media contact this family member?
 

Interview Information

Rate your level of interest in scheduling an interview:
Availability for Interview (Specific Dates & Times):
What would you like to talk about in your interview?
What is your military job description in civilian terms?
How does your job contribute to the overall mission?
Have you been involved in any contingency operations, exercises or humanitarian operations? If so what was your role.
What volunteer work or activities that you do that promotes your military service to the community?
Do you have a family military history? If yes, please explain.
What additional details should the media know about you?
  • Army
  • Marines
  • Navy
  • Air Force
  • Coast Guard
  • National Guard

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