WARRANT OFFICER (REGULAR) APPLICATION

This document provides instructions and forms to complete a

Warrant Officer (Regular) 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 (Reg) 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 as

well as in fillable format. If using the electronic form,

refer to the template for guidance. The rest of the

endorsements should follow standard naval format.

3. Complete and sign your application letter. A template

application letter is provided as well as a fillable form

which can be signed electronically.

4. Complete the top half of the data sheet.

5.

Ensure a promotion type photo has been included in your

package and submitted to MMRP for inclusion in OMPF

within a year of the board date.

6.

Provide certified copies of the following Marine Corps

Total 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.

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.

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, body

markings, 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 entries documenting

your tattoo(s).

14.

Letters of recommendation, letters to the board

president, professional certificates/certifications, and

college degrees and/or transcripts may be attached as

applicable.

15.

If dual or naturalized citizen, provide a copy of your

birth certificate or other required citizenship documents

(if BIR reflects citizenship as alien).

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.

10.

Complete the tattoo screening form and tattoo

statement of understanding.

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

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

____ ACT/SAT TEST SCORES (IF APPLICABLE)

____ CERTIFIED COPY OF SRB PAGE 11 (ENSURE FRATERNIZATION STATEMENT IS

REFLECTED)

____ 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

____ SUPPORTING MEDICAL DOCUMENTATION (AS APPLICABLE)

ENDORSEMENTS

REQUIRED:

•

ALL MARINES ARE REQUIRED TO OBTAIN A COMMANDER’S ENDORSEMENT

AT EACH LEVEL OF COMMAND (UP TO THE FIRST GENERAL OFFICER IN

THE MARINE'S ENDORSING CHAIN OF COMMAND)

•

COMMANDERS MUST ENSURE THAT THEIR ENDORSEMENT, DENOTING

THEIR LEVEL OF CONFIDENCE, IS PROMPTLY RETURNED TO THE

MARINE PRIOR TO THE APPLICATION DEADLINE. COMMANDS ARE NO

LONGER AUTHORIZED TO MAIL THEIR ENDORSED APPLICATIONS TO

MCRC SINCE THE MARINE SUBMITS THEIR OWN APPLICATION VIA

ENCRYPTED EMAIL TO [email protected].

•

COMMANDS MUST ENSURE THAT ALL MARINES RECEIVE ORIGINALS OF

THEIR LETTERS OF ENDORSEMENT. ANY COMMAND AT RISK OF NOT

RETURNING ITS ENDORSEMENT TO THE MARINE WITH A SUFFICIENT

CUSHION PRIOR TO THE APPLICATION DEADLINE SHOULD IMMEDIATELY

NOTIFY 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 00

0 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 (REGULAR) PROGRAM

1. The information contained in the basic application and the

enclosures has

been 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

(Regular) 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/or

description) 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 commanding

officer 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 specifically

address 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 be

fully justified by the commanding officer. (Omit this paragraph if it

does not apply.)

6.

If the endorsement is "Not recommended" or is otherwise derogatory

or 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 (REGULAR) PROGRAM

1. The information contained in the basic application and the

enclosures has

been 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 (Regular) 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 time

Total

___:____ ( )

(____)

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

3.

_______________________________________________________________________

___________________________________________________________________________

4.

_______________________________________________. _______________________

____________________________________________________________________________

Movement to Contact ____ (____)

____ (____)

Ammo Lift

Maneuver under Fire

Total

___:____ ( )

(____)

Rank FNAME MI LNAME

EDIPI

PMOS

Originating Code and Date

(1)

19

Recommended with

19

____________________________________________________________________________

5.

_______________________________________________________________________

____________________________________________________________________________

________________________________

SSIC

CODE

DATE

From: Grade, Full Name, EDIPI, MOS, and USMC/USMCR

To: Commandant of the Marine Corps

Via: Immediate commanding officer and endorsing chain of command

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

OFFICER PROGRAM (REGULAR)

Ref: (a) SECNAVINST 1412.9B

(b) MCO 1040.42A

(c) Announcement MARADMIN

Encl: (1) Data Sheet

(2) Photograph

(3) Certified MCTFS Screens (BIR/BTR, Education, Awards,

Chronological Order, Test)

(4) Test Scores (if qualifying with ACT/SAT)

(5) NAVMC (11) with Fraternization Statement

(6) Security Clearance Verification Letter

(7

) NJP and Statement (if applicable)

(8) Tattoo Screening Form/Tattoo Statement of Understanding

(9) Tattoo Photos and Page 11 (if applicable)

(10) Letters of Recommendation (if applicable)

(11) Letters to the Board President (if applicable)

(12) Professional Cerrtificates (if applicable)

(13) College Transcripts (if applicable)

(14) Medical Submission (DD 2808 and 2807 and as applicable)

1.

I am eligible and apply for the Fiscal Year (XX) Warrant Officer

Program (Regular) as outlined in references (a) and (c).

Enclosures (1) through (14) (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 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 und

er

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 not

included in 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 (REGULAR)

g.

I have a NAC/Background Investigation (BI)/Special Background

Investigation (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 mos

XX 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 a

ccept

any MOS

in which the board

considers me

qualified.”

i. "No UPB is provided due to no record of disciplinary action." OR

Provide 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 first

and second choice MOSs (if applicable).

n. Unit and applicant telephone number and point

of contact.

(Indicate your admin

office’s DSN or commercial numbers on

ly. D

O 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: __________________________________________________________________

__________________________________________________________________

S

ubj: REQUEST FOR APPOINTMENT UNDER THE FISCAL YEAR _

____ WARRANT OFFICER

PROGR

AM (REGULAR)

Ref: _________________________________

_________________________________

Encl:

__________________________________________________________________

_______________________________________________________________

___

__________________________________________________________________

1.

I am eligible and apply for the Fiscal Year _____ Enlisted to Warrant

Officer (Regular) Program as outlined in references (a) through (c).

Enclosures

(___)

thr

ough

(___)

are

attache

d

as

requested.

T

he

following

information

is

submitted:

a.

I require a waiver for the following: _____________________________

____________________________________________________________________________

c

.

Da

te

of Birth: ___________.

b

.

“I, _________________________, if selected for appointment to WO

and upon

acceptance of such appointment, agree to remain on active duty

f

or a period

of

not

less

than

3 years,

unless so

oner separated for

cause

und

er the provisions

of

SE

CNAVINST 1920.6C, Administrative Separation

of

Of

ficers.

I understand

t

hat

this

obligation will run

co

ncurren

tly with

any oth

er leg

al obligation

in

f

or

ce and

will

not serve to decrease any

such obligation.”

(1)

2019

(1) Data Sheet

(2) Photograph

(3) Certified MCTFS Screens (BIR/BTR, Education, Awards,

Chronological Order, Test)

(4) Test Scores (if qualifying with ACT/SAT)

(5) NAVMC 118(11) with Fraternization Statement

(6) Security Clearance Verification Letter

(7) NJP and Statement (if applicable)

(8) Tattoo Screening Form/Tattoo Statement Of Understanding

(9) Tattoo Photos (if applicable)

(10) Letters of Recommendation (if applicable)

(11) Letters to the Board President (if applicable)

(12) Professional Certificates (if applicable)

(13) College Transcripts (if applicable)

(14) Medical Submission (DD 2808 and 2807 and as applicable)

2019

1

(a) SECNAVIST 1412.9B

N/A or list waivers.

(b) MCO 1040.42A

(c) Announcement MARADMIN

Subj: REQUEST FOR APPOINTMENT UNDER THE FISCAL YEAR ______ WARRANT

OFFICER PROGRAM (REGULAR)

e. List off duty education courses: _________________________________

f.

List military schools and correspondence courses completed (include

schools now attending and/or correspondence course(s) currently enrolled in,

if applicable): ___________________________________________________________

____________________________________________________________________________

g.

____________________________________________________________________

____________________________________________________________________________

h.

Active naval service as of _______________________: _________________

____________________________________________________________________________

j.

Recent photo per reference (c) 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.

____________________________________________________________________________

d.

Permanent

grade and Dat

e of Rank: _____, ________________.

____________________________________________________________________

m.

List years of actual experience and key billets held in first

and second choice MOSs (if applicable).

Position/Years: ___________________________________________________________

Job Description: __________________________________________________________

___________________________________________________________________________

2019

Only list if not included in

MCTFS education screen.

Only list if not included in MCTFS education screen.

I have a NAC/Background Investigation (BI)/Special Background

Investigation (SBI) completed by the Defense Investigative Service on

(date); or I do not have a NAV/BI/SBI, but I initiated one on (date).

1 Feb 2019

XX years XX mos

XX days. If other than naval service is included in your Armed Forces Active

Duty base date, include branch, periods of service and highest grade held.

"No UPB is provided due to no record of disciplinary action." OR

Provide NJP and statement addressing 5 Ws as separate enclosure.

Posit

ion/Years: _____________________________________

____________

__________

Job Description: __________________________________________________________

___________________________________________________________________________

Position/Years: ___________________________________________________________

Job Description: __________________________________________________________

___________________________________________________________________________

Subj: REQUEST FOR APPOINTMENT UNDER THE FISCAL YEAR ______ WARRANT

OFFICER PROGRAM (REGULAR)

Pos

ition/Years:

___________________________________________________________

Job

Description:

__________________________________________________________

___________________________________________________________________________

Position/Years:

___________________________________________________________

Job

Description:

__________________________________________________________

___________________________________________________________________________

Position/Years:

___________________________________________________________

Job

Description:

__________________________________________________________

___________________________________________________________________________

Position/Years: ___________________________________________________________

Job Description: __________________________________________________________

___________________________________________________________________________

Posit

ion/Years: _____________________________________

____________

__________

Job Description: __________________________________________________________

___________________________________________________________________________

2019

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: __________________________________________________________

___________________________________________________________________________

Subj: REQUEST FOR APPOINTMENT UNDER THE FISCAL YEAR ______

WARRANT

OFFICER PROGRAM (REGULAR)

Position/Years: ___________________________________________________________

Job Description: __________________________________________________________

___________________________________________________________________________

2019

DATA SHEET FOR REGULAR WARRANT OFFICER PROGRAM

COLUMN 1

COLUMN 2

____________________________

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.

ACTIVE NAVAL SERVICE (AS OF 1 FEB ___)

K.

EL/SAT/ACT TEST SCORE:

(Circle one)

===============HQMC=========

=====ACTION================ONLY============

WO(REG) PROGRAM

CHECKLIST WAIVERS REQUIRED

TATTOO PHOTOS

PHOTOGRAPH

SRB PAGES (12,11,9,3)

ROS (SGTS ONLY)

EDU

BIR/BTR ENDORSEMENTS

US CITIZEN RECOMMENDED

ANS 8 – 20 NOT RECOMMENDED

EL > 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 ALL

APPLICANTS

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.

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 AND

CRITICAL READING ONLY)

• OFFICIAL ACT COLLEGE REPORT – COMBINED ENGLISH AND MATH

SCORE OF 39 OR A COMPOSITE SCORE OF 22

• MINIMUM ELECTRONICS REPAIR (EL) COMPOSITE SCORE OF 110

DERIVED FROM THE ARMED SERVICES VOCATIONAL APTITUDE BATTERY

(ASVAB) OR THE ARMED FORCES CLASSIFICATION TEST (AFCT)

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 EL SCORE.

ONLY EL 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 official

record:

a. Name: Marine Full Name/EDIPI/PMOS

b. Clearance: Investigation – PRSC (YYYYMMDD) OPM

NACLC (YYYYMMDD) OPM

ENAC (YYYYMMDD) OPM

Eligibility – SECRET (YYYYMMDD) DoNCAF

U.S. Access - Secret

2. Add sentence here if eligibility has expired and new

investigation 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), defense

system 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 official

record:

a. Name: ______________________________________________

b. Clearance: Investigation – PRSC (__________) OPM

NACLC (__________) 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 ARE

FILLED OUT

o IF YES TO TATTOOS ENSURE BODY LOCATIONS ARE DOCUMENTED

ON 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 FORM

Insert 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, body

markings, 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 partially

exposed 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 standard

PT 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 membership

or 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 for

membership initiation, or as the result of any violation of law(s))?

Y _____N______

USMC OFFICER TATTOO SCREENING FORM

Insert into MCRCO 1100.2A, Appendix O, Updated by MCRC FROST CALL 017-16

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, NROTC

Unit, 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 reviewed

to 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 female

applicants 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 or

location 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. __________________________________

USMC OFFICER TATTOO SCREENING FORM

Insert into MCRCO 1100.2A, Appendix O, Updated by MCRC FROST CALL 017-16

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 you

understand 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 that

are 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 are

affiliated 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 warm

weather 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 the

tattoos, 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.

•

EL SCORE WAIVER

o

A WAIVER OF THE EL TEST SCORE REQUIREMENT WILL BE

CONSIDERED ONLY IF THE MARINE HAS AN ARMED FORCES

QUALIFICATION TEST SCORE OF 70 OR GREATER.

o

REQUESTS FOR WAIVERS SHALL BE SUBMITTED AS A PART OF

THE MARINE'S BASIC LETTER, AND A RECOMMENDATION FOR

WAIVER APPROVAL MADE IN THE GO'S ENDORSEMENT AT THE

MAJOR SUBORDINATE COMMAND LEVEL.

• OTHER WAIVERS

o

REQUESTS FOR A WAIVER OF THE ELIGIBILITY REQUIREMENTS

AND EXCEPTION TO POLICY, EXCEPT THOSE ESTABLISHED AS

UNWAIVERABLE BY LAW OR SPECIFIED AS UNWAIVERABLE BY

THE MARADMIN, MAY BE CONSIDERED ON A CASE-BY-CASE

BASIS BY THE CG, MCRC.

o

REQUESTS FOR WAIVER OF DISCIPLINARY ACTION REQUIREMENTS

MUST INCLUDE APPROPRIATE JUSTIFICATION.

TATTOO DOCUMENTATION

• TATTOO PHOTOS

• REQUIRED IF APPLICANT HAS EVER OR CURRENTLY HAS ANY

TATTOOS, BRANDS, BODY MARKINGS, OR BODY ORNAMENTATION

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

ANGLES)

• MUST PROVIDE CLOSE UP COLOR PHOTOS FOR EACH TATTOO (IF

NOT 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 A

NAVMC 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 NOT

VISIBLE 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 4

ANGLES - 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 APPROPRIAT E PHOTO.

PTGEAR PHOTOS

(GREEN ON GREEN PT GEAR ONLY)

I

RANK

I

NAME

I

EDIPll

LEFT PROFILE

RIGHT PROFILE

FRONT PROFILE

REAR PROFILE

I

RANK

I

NAME

I

EDIPl

l

TATIOO

NUMBER

ONE

TATIOO

NUMBER

TWO

SIZE:

SIZE

:

DESCRIPTION

:

DESCRIPTION

:

LOCATION

:

LOCATION:

MEANING: MEANING:

TATIOO

NUMBER

THREE

TATIOO

NUMBER

FOUR

SIZE:

SIZE

:

DESCRIPTION

:

DESCRIPTION:

LOCATION

:

LOCATION:

MEANING

:

MEANING:

I

RANK

I

NAME

I

EDIPl

l

TATIOO

NUMBER

FIVE

TATIOO

NUMBER

SIX

SIZE:

DESCRIPTION

:

DESCRIPTION

:

LOCATION:

MEANING:

TATIOO

NUMBER

SEVEN

TATIOO

NUMBER

EIGHT

SIZE: SIZE:

DESCRIPTION: DESCRIPTION:

LOCATION:

MEANING:

I

RANK

I I

NAME

'

I

EDIP

ll

TATIOO

NUMBER

NINE

TATIOO

NUMBER

TEN

SIZE

:

SIZE

:

DESCRIPTION

:

DESCRIPTION:

LOCATION

:

LOCATION:

MEANING

:

MEANING

:

TATIOO

NUMBER

ELEVEN

TATIOO

NUMBER

lWELVE

SIZE:

SIZE

:

DESCRIPTION

:

DESCRIPTION:

LOCATION

:

LOCATION:

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 IS

AUTHORIZED TO VERIFY)

o FORM N-560/N-561 CERTIFICATE OF CITIZENSHIP

o FORM N-550/N-551 CERTIFICATE OF NATURALIZATION

o DS FORM 1350 CERTIFICATION OF BIRTH

o FS FORM 545 CERTIFICATION OF BIRTH ABROAD

o FS FORM 240 REPORT OF BIRTH ABROAD OF CITIZENS OF THE

US

o 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 OR

2 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 NUMBER

MUST BE DOCUMENTED ON THE DD FORM 2808 AND AS A SEPARATE ENCLOSURE

o

RESULTS OF AN UPDATED AUDIOGRAM MUST BE DOCUMENTED ON THE DD FORM

2808 AND/OR A SEPARATE ENCLOSURE

o

PAP PATHOLOGY RESULTS MUST BE DATED WITHIN 3 YEARS

o ALL SUPPORTING DOCUMENTS FOR ANY SURGURIES TO INCLUDE PRE AND POST

OPERATIVE PAPERWORK

o YES ANSWERS ON DD FORM 2807 MUST BE EXPLAINED BY A PHYSICIAN IN

BLOCK 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.