Thank you for your interest in applying to the U.S. VRC.  Our on-line application will take approximately 30 minutes to complete. You will need copies of your DD 214 or other service records, state issued licenses, certification certificates and school transcripts (unofficial will do) to submit with this application, Please gather and have electronic versions of those documents (pdf preferred) to attach to and submit with this application.
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Email *
Last Name *
First Name *
Middle Initial *
Date of Birth *
Home Street Address *
City *
State *
Zip Code *
Home Phone # XXX-XXX-XXXX *
Cell Phone # XXX-XXX-XXXX *
Cell phone text enabled *
Secondary personal email
Emergency contact Name
Emergency contact relationship *
Emergency contact phone number (xxx-xxx-xxxx) *
1. Have you ever been rejected for induction, enlistment or appointment by any branch of the    Armed Forces of the United States? *
2. If previously in any branch of the U.S. Armed Forces, were you ever the subject of military    disciplinary action? ( e.g. Courts Martial, non-judicial punishment) *
3. Have you ever been Dishonorably Discharged or discharged under less than honorable conditions from any branch of the U.S. Armed Forces, or from State or Local Service? *
4. Are you a citizen of the United States (by birth or naturalization)? *
5. Have you ever served in the Armed Forces of, or sworn allegiance, to another country? *
6. Have you ever, in your lifetime, knowingly been a member of any organization that advocates the overthrow of the United States by unconstitutional means or have you ever contributed money to any such organization? (NOTE: This includes any organization whose intent is to prevent others from exercising their rights under the U.S. Constitution or laws of the United States or of any state group that seeks to overthrow the government of the United States, or any subdivision thereof, by unconstitutional and/or unlawful means)? *
7. Have you ever, in your lifetime, been employed by, acted as a consultant for, or acted on behalf of, any foreign government, firm or agency? *
8. Have you ever been investigated, arrested, detained or convicted of a felony offense that    carried a penalty of imprisonment of more than one (1) year including any crime for which    forfeiture of collateral is the prescribed punishment? (This includes violation of any U.S.    Military, U.S. civilian or foreign laws) *
9. Have you ever been convicted of a crime of domestic violence or domestic assault or are you currently subject to the order of any U.S. court restraining you from harassing, stalking, or threatening your child or intimate partner or child of such partner (or any other persons)? *
10. Have you ever engaged in deceptive or illegal financial practices such as embezzlement,      employee theft, check fraud, income tax evasion, expense account fraud, filing deceptive      loan statements or any other intentional financial breach of trust? *
11. Are you a currently a member of the National Guard or any Reserve Component  of the Armed Forces of the United States, an MOB designee, a current member of another state's authorized State Defense Force or a member of any unorganized militia? *
12. Have you been Honorably Discharged or Retired, from any branch of the U.S. Armed  Forces? (If yes, Please include a copy of your DD-214) *
I understand the the U.S. VRC will conduct a criminal background check on my submission of this application and consent to such a background check *
How did you find out about the U.S. VRC?
Do you have prior federal or state military service? *
Branch or State
Years of Military Service
Highest Military Rank/Grade Held
MOS/RATE/AFSC (N/A if not so classified)
Current employment- Job title *
Completed high school or Equivalence *
Completed Associate's Degree *
Completed Bachelor's  Degree *
Completed Master's  Degree *
Completed Doctorate *
Associates Degree Institution and Major
Bachelors Degree Institution and Major
Masters Degree Institution and Major
Doctorate/post graduate Institution and Degree, Major, or Specialty
Do you hold a state issued license? *
Drivers license and license number (1)
state of issuance (1)
expiration date (1)
Type of license and license number (2)
state of issuance (2)
expiration date (2)
Type of license and license number (3)
state of issuance (3)
expiration date (3)
Additional Skills and Training that would be relevant
I have read the Non-disclosure Agreement dated 23 MARCH 2021 at the attached link and agree to its provisions. Located at: https://drive.google.com/file/d/1dqmkIwEpmnKZFMYnmDuwFVpDaNvi5nwq/view?usp=sharing *
I have read the Hold Harmless Agreement dated 23 MARCH 2021 at the attached link and agree to its provisions. Located at: https://drive.google.com/file/d/19e2S_ldTdpI-4dMel2BUAIJQK7P5oGai/view?usp=sharing *
First name, MI, Last name, suffix (Typing my name is equivalent to my signing agreement to the above information) *
Date of submission *
Document submission- **You'll need to email supporting documents to  recruiter@us-vrc.org. Supporting documents include: DD214, service records, transcripts, licenses, explanations, other relevant documents. Acknowledge understanding of documentation requirements? *
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