PERSONNEL SECURITY SCREENING QUESTIONNAIRE
INTRODUCTION
You are here today because you either enlisted with a guaranteed skills job or are being considered for one because of your qualifications. Since these jobs involve matters of national security, it is imperative that you answer the questions on this questionnaire honestly. Your answers to these questions will determine how extensive your interview will be when you are called.
PERSONAL INFORMATION |
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1. Are you, any of your family members and/or anyone you have lived with, not a citizen of the U.S.?
2. Were any of your family members born outside the U.S.? Does not include births abroad of U.S. parents.
3. Do you have any friends, relatives or know persons who are U.S. citizens that live outside of the U.S.?
4. Do you or any family members maintain or claim dual citizenship with a country other than the U.S.?
5. Have you ever traveled outside of the U.S., including Canada or Mexico, for any purpose?
6. Do you have any friends or relatives that are involved in any criminal misdemeanor and felony activities?
7. Do you have any friends or relatives that are presently in jail, prison, parole or probation?
8. Have you ever been rejected by any branch of the armed forces for enlistment or affiliation due to any reason other than medical?
9. Have you ever been charged or punished under the UCMJ, received non-judicial punishment, been convicted by a military court, investigated by a military agency, relieved of duties or had adverse entries in your service record or on your evaluations or recruit hard card?
10. Have you ever been fired from a job?
11. Have you ever left a job under other than favorable conditions (left due to allegations of misconduct or bad performance)?
12. During high school or college, were you ever suspended, expelled, or disciplined for any reason?
13. Have you ever had any bills turned over to a collection agency?
14. Have you ever paid a bill more than 30 days late or not at all?
15. Have you ever bounced a check, overdrawn your debit card, had a credit card recalled, anything repossessed or voluntarily surrendered to a creditor?
16. Have you ever filed for bankruptcy?
17. Have you ever had debt judgments or liens filed against you?
18. Do you owe any individual or persons money, for any reason?
19. Does your monthly payment debt (i.e. credit cards, car payments, insurance, medical bills, record/health/book clubs, etc.) exceed 50 percent of your monthly income?
20. Have you ever received an Other Than Honorable discharge from any branch of the military?
21. Have you ever shoplifted or stolen anything, whether charged or not?
22. Have you ever been charged with or convicted of a felony, misdemeanor, or any offense other than traffic violations (whether the charges were dropped or not)?
23. Are there any charges pending against you now?
24. Have you ever used, bought, sold, grown, manufactured or possessed marijuana?
25. Have you ever used, possessed or experimented with any type of controlled substance, narcotic or drug, other than marijuana?
26. Have you ever taken someone else’s prescription medication.
27. Have you ever been convicted of an alcohol related offense?
28. Have you ever been told to enter, or have you ever been in an alcohol or drug program?