DA Form 61 Application for Appointment

What Is DA Form 61?

DA Form 61, Application for Appointment is mainly used to get an appointment as a commissioned or warrant officer in the United States Army Reserve or Regular Army, as well as to apply for attending the U.S. Army Officer Candidate School.

The application - sometimes confused with the DD Form 61, Request For Nomenclature - was last revised by the Department of the Army (DA) in June 1981. An up-to-date fillable DA Form 61 is available for digital filing and download below or can be found on the Army Publishing Directorate website.

All the information in the document is used as the basis for determining the qualifications and background information on possible applicants and is provided voluntarily. If the candidate fails to disclose the necessary data, the DA 61 will not be accepted.

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APPLICATION FOR APPOINTMENT
For use of this form, see AR 135-100, AR 145-1, AR 351-5, and AR 601-100; the proponent agency is DCSPER
DATA REQUIRED BY THE PRIVACY ACT OF 1974
Title 10 United States Code, Section 3012 (Title 5 United States Code, Section 552a)
AUTHORITY:
To obtain an appointment as a commissioned or warrant officer in the Regular Army or Army Reserve, or to obtain selection to attend the US Army Officer Candidate
PRINCIPAL PURPOSE:
School.
Basis for determination of qualifications and background information for eligibility for consideration for appointment as a Regular Army or Army Reserve
ROUTINE USES:
commissioned/warrant officer or for selection for attendance at the US Army Officer Candidate School.
Disclosure of information requested in DA Form 61 is voluntary. Failure to provide the required information will result in non-acceptability of the application.
DISCLOSURE
2. GOVERNING REGULATION OR CIRCULAR (Specify appropriate section(s) if applicable)
1. TYPE OF APPOINTMENT FOR WHICH APPLICATION IS SUBMITTED
COMMISSIONED OFFICER - REGULAR ARMY
3. GRADE FOR WHICH APPLYING (Reserve appointments only)
COMMISSIONED OFFICER - ARMY RESERVE
4.
SOURCE OF APPLICATION (ROTC only)
WARRANT OFFICER - REGULAR ARMY
DMG
DATE DESIGNATED:
WARRANT OFFICER - ARMY RESERVE
SCHOLARSHIP - ENTER 1, 2, 3 OR 4 YEARS:
OFFICER CANDIDATE SCHOOL
5. ONLY FOR APPLICANTS FOR APPOINTMENT AS WARRANT OFFICERS
(List choice by MOS code and title)
6.
BRANCH AND SPECIALTY PREFERENCES
a. MOS CODE
b. MOS TITLE
Regular Army and Officer Candidate applicants and all ROTC graduates:
In numerical sequence, indicate 10 branch preferences other than CA and SS.
USAR applicants: If applying for a specific Reserve vacancy, indicate
ONLY the
branch of the vacant position; all other applicants may enter more than one branch.
PERSONAL DATA
7. NAME (Last, first, middle)(Explain variations from birth certificate in Item 41)
8. GRADE
9a. SOCIAL SECURITY NUMBER
PREFER-
BRANCH
SPECIALTY
ENCE
10. BRANCH
11. TOTAL YRS
12. MARITAL
13. NUMBER OF DEPENDENTS UNDER 18
9b. SELECTIVE SERVICE NUMBER
(MOS if enl or wo)
ACTIVE SERVICE
STATUS
YEARS OF AGE
AD
14. DATE OF
16. SEX
17. COMPLETE MILITARY ADDRESS
(If presently on active duty) (Include ZIP Code)
15. PLACE OF BIRTH (City, county,
AG
BIRTH
state)
AR
AV
PHONE AND/OR AUTOVON NUMBER
CA
18. PERMANENT ADDRESS (Include ZIP Code)
19. CURRENT MAILING ADDRESS (If difference from Item 18) (Include ZIP Code)
CM
EN
FA
PHONE (Include area code)
PHONE (Include area code)
FI
a. NATIVE
b.
20. US
c. APPLICANT'S CERTIFICATE NO. (If Item b. checked) (Date, place, court)
IN
NATURALIZATION
CITIZEN
MI
YES
YES
DERIVED
MP
NO
IMMIGRANT
NO
OD
21. CIVILIAN EDUCATION (See page 3 for additional requirements for professional personnel)
QM
a. HIGH SCHOOL GRADUATE
b. NAME AND LOCATION OF HIGH SCHOOL
SC
YES
NO
SS
(4)
TC
(2)
c. NAME AND LOCATION OF EACH COLLEGE
(3)
(5)
DATE GRADUATED
(1)
SEMESTER
OR UNIVERSITY ATTENDED (Include USMA,
YEARS
MAJOR
AN
OR WILL GRADUATE
DEGREE
CREDITS
USNA, USAFA, USCGA, and USMMA)
ATTENDED
SUBJECT
EARNED
DAY
MONTH
YEAR
CH
DE
JA
MC
MS
d. SPECIAL EDUCATIONAL HONORS, SCHOLAR-
e. IF YOU HAVE EVER BEEN EXPELLED FROM SCHOOL, OR PLACED ON PROBATION, EITHER FOR
SP
SHIPS, ETC.
ACADEMIC OR DISCIPLINARY REASONS, EXPLAIN (Continue in Item 41(Remarks))
VC
22.
HIGHEST LEVEL SERVICE SCHOOL ATTENDED
COMPLETED
c. DATES (Mo-Yr)
a. NAME OF SCHOOL
b. COURSE
d. IF NOT COMPLETED GIVE REASON
FROM
TO
YES
NO
23a. FOREIGN LANGUAGES AND DEGREE OF PROFICIENCY
b. ALAT SCORE (If applicable)
DA FORM 61, JUN 1981
APD LC v2.01ES
EDITION OF 1 AUG 74 AND DA FORM 61-R, 26 SEP 75, PRIVACY ACT STATEMENT, ARE OBSOLETE.
APPLICATION FOR APPOINTMENT
For use of this form, see AR 135-100, AR 145-1, AR 351-5, and AR 601-100; the proponent agency is DCSPER
DATA REQUIRED BY THE PRIVACY ACT OF 1974
Title 10 United States Code, Section 3012 (Title 5 United States Code, Section 552a)
AUTHORITY:
To obtain an appointment as a commissioned or warrant officer in the Regular Army or Army Reserve, or to obtain selection to attend the US Army Officer Candidate
PRINCIPAL PURPOSE:
School.
Basis for determination of qualifications and background information for eligibility for consideration for appointment as a Regular Army or Army Reserve
ROUTINE USES:
commissioned/warrant officer or for selection for attendance at the US Army Officer Candidate School.
Disclosure of information requested in DA Form 61 is voluntary. Failure to provide the required information will result in non-acceptability of the application.
DISCLOSURE
2. GOVERNING REGULATION OR CIRCULAR (Specify appropriate section(s) if applicable)
1. TYPE OF APPOINTMENT FOR WHICH APPLICATION IS SUBMITTED
COMMISSIONED OFFICER - REGULAR ARMY
3. GRADE FOR WHICH APPLYING (Reserve appointments only)
COMMISSIONED OFFICER - ARMY RESERVE
4.
SOURCE OF APPLICATION (ROTC only)
WARRANT OFFICER - REGULAR ARMY
DMG
DATE DESIGNATED:
WARRANT OFFICER - ARMY RESERVE
SCHOLARSHIP - ENTER 1, 2, 3 OR 4 YEARS:
OFFICER CANDIDATE SCHOOL
5. ONLY FOR APPLICANTS FOR APPOINTMENT AS WARRANT OFFICERS
(List choice by MOS code and title)
6.
BRANCH AND SPECIALTY PREFERENCES
a. MOS CODE
b. MOS TITLE
Regular Army and Officer Candidate applicants and all ROTC graduates:
In numerical sequence, indicate 10 branch preferences other than CA and SS.
USAR applicants: If applying for a specific Reserve vacancy, indicate
ONLY the
branch of the vacant position; all other applicants may enter more than one branch.
PERSONAL DATA
7. NAME (Last, first, middle)(Explain variations from birth certificate in Item 41)
8. GRADE
9a. SOCIAL SECURITY NUMBER
PREFER-
BRANCH
SPECIALTY
ENCE
10. BRANCH
11. TOTAL YRS
12. MARITAL
13. NUMBER OF DEPENDENTS UNDER 18
9b. SELECTIVE SERVICE NUMBER
(MOS if enl or wo)
ACTIVE SERVICE
STATUS
YEARS OF AGE
AD
14. DATE OF
16. SEX
17. COMPLETE MILITARY ADDRESS
(If presently on active duty) (Include ZIP Code)
15. PLACE OF BIRTH (City, county,
AG
BIRTH
state)
AR
AV
PHONE AND/OR AUTOVON NUMBER
CA
18. PERMANENT ADDRESS (Include ZIP Code)
19. CURRENT MAILING ADDRESS (If difference from Item 18) (Include ZIP Code)
CM
EN
FA
PHONE (Include area code)
PHONE (Include area code)
FI
a. NATIVE
b.
20. US
c. APPLICANT'S CERTIFICATE NO. (If Item b. checked) (Date, place, court)
IN
NATURALIZATION
CITIZEN
MI
YES
YES
DERIVED
MP
NO
IMMIGRANT
NO
OD
21. CIVILIAN EDUCATION (See page 3 for additional requirements for professional personnel)
QM
a. HIGH SCHOOL GRADUATE
b. NAME AND LOCATION OF HIGH SCHOOL
SC
YES
NO
SS
(4)
TC
(2)
c. NAME AND LOCATION OF EACH COLLEGE
(3)
(5)
DATE GRADUATED
(1)
SEMESTER
OR UNIVERSITY ATTENDED (Include USMA,
YEARS
MAJOR
AN
OR WILL GRADUATE
DEGREE
CREDITS
USNA, USAFA, USCGA, and USMMA)
ATTENDED
SUBJECT
EARNED
DAY
MONTH
YEAR
CH
DE
JA
MC
MS
d. SPECIAL EDUCATIONAL HONORS, SCHOLAR-
e. IF YOU HAVE EVER BEEN EXPELLED FROM SCHOOL, OR PLACED ON PROBATION, EITHER FOR
SP
SHIPS, ETC.
ACADEMIC OR DISCIPLINARY REASONS, EXPLAIN (Continue in Item 41(Remarks))
VC
22.
HIGHEST LEVEL SERVICE SCHOOL ATTENDED
COMPLETED
c. DATES (Mo-Yr)
a. NAME OF SCHOOL
b. COURSE
d. IF NOT COMPLETED GIVE REASON
FROM
TO
YES
NO
23a. FOREIGN LANGUAGES AND DEGREE OF PROFICIENCY
b. ALAT SCORE (If applicable)
DA FORM 61, JUN 1981
APD LC v2.01ES
EDITION OF 1 AUG 74 AND DA FORM 61-R, 26 SEP 75, PRIVACY ACT STATEMENT, ARE OBSOLETE.
24. ARE YOU NOW, OR HAVE YOU EVER BEEN A CONSCIENTIOUS OBJECTOR?
YES
NO (If yes, attach affidavit)
25.
I UNDERSTAND THAT, IF I AM SELECTED FOR APPOINTMENT, I WILL BE EXPECTED TO ACCEPT SUCH ASSIGNMENTS AS ARE IN THE BEST INTEREST OF THE SERVICE
REGARDLESS OF MY MARITAL STATUS AND/OR RESPONSIBILITY FOR DEPENDENTS; AND IT IS MY RESPONSIBILITY TO MAKE APPROPRIATE ARRANGEMENTS FOR THE CARE
OF MY DEPENDENTS SHOULD I BE REQUIRED TO PERFORM DUTY IN AN AREA WHERE DEPENDENTS ARE NOT PERMITTED.
26.
HAVE YOU EVER UNDER EITHER MILITARY OR CIVILIAN LAW BEEN INDICTED OR SUMMONED IN TO COURT AS A DEFENDANT IN A CRIMINAL PROCEEDING (Including any
proceedings involving juvenile offenses, article 15, UCMJ, and any court-martial) REGARDLESS OF THE RESULT OF TRIAL, OR CONVICTED, FINED, IMPRISONED, PLACED ON
PROBATION, PAROLED OR PARDONED, OR HAVE YOU EVER BEEN ORDERED TO DEPOSIT BAIL OR COLLATERAL FOR THE VIOLATION OF ANY LAW, POLICE REGULATION OR
ORDINANCE? (Exclude traffic violations involving a fine or forfeiture of $100 or less).
YES
NO
IF YES, ATTACH REQUEST FOR WAIVER LISTING THE DATE, THE NATURE OF EACH ALLEGED OFFENSE OR VIOLATION, THE NAME AND LOCATION OF
THE COURT OR PLACE OF HEARING, AND THE PENALTY IMPOSED OR OTHER DISPOSITION OF EACH CASE AND FURNISH COPY OF COURT ACTION OR DETAILED STATEMENT IN
AFFIDAVIT FORM AS TO THE OUTCOME OF EACH CASE.
27. ACTIVE MILITARY SERVICE (Indicate tour with each organization separately - show ROTC Camps in Item 39)
d. PRIOR
a. ORGANIZATION
b. DATES (Day, Month, Year)
c. BRANCH/MOS
e. HIGHEST GRADE
SERVICE NO.
(US Armed Forces, USCG, NOAA,
(As appropriate)
AND COMPONENT
FROM
TO
(If applicable)
US Public Health Service, Peace Corps)
f. DATE CURRENT ACTIVE DUTY TOUR TERMINATES
g. DATE OF LAST ADL PROMOTION
28. RESERVE OR NATIONAL GUARD SERVICE (Not on active duty)
a. ORGANIZATION
d. PRIOR
b. DATES (Day, Month, Year)
e. HIGHEST GRADE
c. BRANCH/MOS
(US Armed Forces, USCG, NOAA,
SERVICE NO.
AND COMPONENT
(As appropriate)
FROM
TO
US Public Health Service, Peace Corps)
(If applicable)
29. SOURCE OF CURRENT COMMISSION (If applicable)
30. AWARDS (Do not list theater or service medals)
OTHER
ARNGUS:
OCS
DIRECT APPOINTMENT
USAR:
OCS
ROTC
ROTC (ECP)
ROTC (SMP)
DIRECT APPOINTMENT
31. HAVE YOU EVER APPLIED AND NOT BEEN SELECTED FOR:
a. ROTC
YES
NO
b. OCS
YES
NO
c. APPOINTMENT IN RESERVE COMPONENT (USAR/ARNG)
YES
NO
d. APPOINTMENT IN REGULAR ARMY
YES
NO
AS A WARRANT OFFICER
AS A WARRANT OFFICER
AS A COMMISSIONED OFFICER
AS A COMMISSIONED OFFICER
e. IF ANSWER IS "YES", EXPLAIN FULLY
32.
ARE YOU NOW OR HAVE YOU EVER BEEN IN THE MILITARY SERVICE OF OR BEEN EMPLOYED BY A FOREIGN GOVERNMENT
(If yes, give dates, country and type of service or
employment)
33.
HAVE YOU EVER RESIGNED OR BEEN ASKED TO RESIGN IN LIEU OF ELIMINATION PROCEEDINGS; BEEN DISCHARGED IN LIEU OF ELIMINATION, FURLOUGHED
(other than
regular furlough or leave),
OR PLACED ON INACTIVE STATUS WHILE SERVING IN THE US ARMED FORCES; OR, HAVE YOU EVER RESIGNED OR BEEN ASKED TO RESIGN FROM
A POSITION WHILE IN PRIVATE OR GOVERNMENT EMPLOYMENT?
(If yes, state circumstances; if more space is required, continue on separate sheet).
YES
NO
APD LC v2.01ES
APPLICANTS FOR
35.
APPLICANTS FOR JUDGE ADVOCATE GENERAL'S CORPS ONLY
34.
CHAPLAINS BRANCH ONLY
RELIGIOUS DENOMINATION BY
BARS OF WHICH YOU ARE A MEMBER (Specify dates)
WHICH YOU WILL BE ENDORSED
36.
APPLICANTS FOR MEDICAL AND DENTAL CORPS ONLY
a. TRAINING
c. DATES (Month and Year)
b. NAME AND LOCATION OF HOSPITAL
FROM
TO
LEVEL
TYPE
INTERNSHIP
RESIDENCY TNG
SPECIALTY TNG
d. SPECIALTY BOARDS
e. DATES OF CERTIFICATION
(Day, Month, Yr)
f. PLACE IN WHICH CURRENTLY LICENSED
37. APPLICANTS FOR ARMY NURSE CORPS AND ARMY MEDICAL SPECIALIST CORPS ONLY
a. NAME OF NURSING OR ACCREDITED PROFESSIONAL SCHOOL
b. LOCATION
d. STATE AND CURRENT REGISTRATION NUMBER
e.
STATE AND DATE OF INITIAL
c. DATES OF ATTENDANCE
(Mo, Yr)
REGISTRATION (Day, Month, Year)
FROM
TO
f. POSTGRADUATE COURSES (Include courses at general hospitals, service schools, and short courses)
(1)
(2)
(3)
SEMESTER
DATES OF ATTENDANCE (Month, Year)
CREDITS
SUBJECT OR COURSE
NAME AND LOCATION OF SCHOOL OR HOSPITAL
EARNED
FROM
TO
38. HAVE YOU BEEN EMPLOYED BY THE US ARMY AS A DIETITIAN, OCCUPATIONAL OR PHYSICAL THERAPIST?
(If yes, give dates)
YES
NO
39.
ARMY ROTC (To be completed only by prospective ROTC graduates applying for appointment in USAR or RA)
SUCCESSFULLY COMPLETED AROTC PROGRAM AS FOLLOWS
DATES ATTENDED (Month and Year)
c. CAMP TRAINING
COURSE
FROM
TO
(1) INSTALLATION (Basic)
COMPLETION DATE (Month, Year)
a. BASIC
(2) INSTALLATION (Advanced/Ranger)
COMPLETION DATE (Month, Year)
b. ADVANCED
40. MAIN CIVILIAN EMPLOYMENT
a. NAME AND ADDRESS OF EMPLOYER
b. JOB TITLE
c. MONTH AND YEAR
FROM
TO
b. PRINCIPAL DUTIES (Describe briefly)
41. REMARKS (Experience, proficiencies and special abilities not shown elsewhere in this application. Those required to enter primary entry specialties, see Para 1-27d,e, AR 601-100). (If more
space is required, attach additional sheet)
DATE
SIGNATURE OF APPLICANT
42. THE INFORMATION CONTAINED HEREIN IS TRUE
TO THE BEST OF MY KNOWLEDGE AND BELIEF.
APD LC v2.01ES
THIS PAGE NOT TO BE COMPLETED BY APPLICANT
PART I - RECOMMENDATION FOR APPOINTMENT OF ROTC GRADUATE AS A (REGULAR) OR
(RESERVE) COMMISSIONED OFFICER OF THE ARMY (AR 601-100, AR 145-1) (To be completed by PMS only)
FROM: (Name and Address of Institution)
TO: (Appropriate Region Commander)
a.
APPLICANT WILL HAVE SUCCESSFULLY COMPLETED AT THIS INSTITUTION THE PRESCRIBED COURSE FOR THE UNIT ON
(Date)
b.
APPLICANT
HAS
HAS NOT COMPLETED SUCCESSFULLY THE REQUIRED CAMP TRAINING.
c.
APPLICANT
WILL HAVE ATTAINED
WILL NOT HAVE ATTAINED, A BACCALAUREATE DEGREE UPON SUCCESSFUL COMPLETION OF THE ROTC COURSE.
d.
I CONSIDER APPLICANT PHYSICALLY, MENTALLY, MORALLY, AND PROFESSIONALLY QUALIFIED FOR APPOINTMENT AS A
REGULAR
RESERVE COMMISSIONED
OFFICER OF THE ARMY RECOMMEND HIS APPOINTMENT.
e.
APPLICANT WILL ATTAIN FULL QUALIFICATION FOR, AND SHOULD BE APPOINTED ON
(Day, Month and Year)
DATE
BRANCH FOR ASSIGNMENT
SIGNATURE AND GRADE
(PMS)
PART II - RECOMMENDATION FOR APPLICANTS FOR OCS ONLY (AR 351-5)
a. STATEMENT
TO:
DATE
1. I HAVE KNOWN THE APPLICANT FOR
MONTHS. HE HAS SERVED UNDER ME FOR
MONTHS. HIS PRINCIPAL DUTY IS
2. I
DO
DO NOT RECOMMEND THE APPLICANT.
3. REMARKS (Include your opinion as to his/her overall ability (to include leadership) and value to the service).
ENCLOSURES
SIGNATURE
ORGANIZATION
TYPED NAME, GRADE AND TITLE
b. STATEMENT
DATE
TO:
1. I HAVE KNOWN THE APPLICANT FOR
MONTHS. HE HAS SERVED UNDER ME FOR
MONTHS. HIS PRINCIPAL DUTY IS
2. I
DO
DO NOT RECOMMEND THE APPLICANT.
3. REMARKS (Include your opinion as to his/her overall ability (to include leadership) and value to the service).
ENCLOSURES
SIGNATURE
ORGANIZATION
TYPED NAME, GRADE AND TITLE
APD LC v2.01ES

Download DA Form 61 Application for Appointment

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DA Form 61 Instructions

It is strongly recommended for all the candidates to contact their Professor of Military Science, in-service career counselor, or local recruiter for the details regarding completing the form DA 61 and related documents. Most sections of the form are self-explanatory, but some may require additional information:

  1. First, the candidate needs to choose the type of appointment to which they are applying to.
  2. The appropriate number of governing regulation or circular and the applying grade for reserve appointment go in Boxes 2 and 3, respectively.
  3. ROTC applicants must fill in Box 4, Source of Application, and applicants for appointment as warrant officers need to complete Box 5. The properly qualified military may enter up to three MOS codes in the corresponding field.
  4. Box 6 requires the choice of branch specialty preferences. It is necessary to indicate at least 10 branch preferences.
    • Male applicants are required to choose two combat support arms, two combat arms, and two combat service support arms. The remaining four are left for an applicant to choose.
    • Females can indicate one combat arm, except IN and AR, 2 combat support arms and 2 combat service support arms. The remaining five can be chosen by an applicant.
    • Warrant Officer Aviators who want to be commissioned have to list AV as the only choice.
  5. Boxes 7 through 20 require detailed personal information about the applicant.
  6. Boxes 21, 22 and 23 reflecting the levels of military education.
  7. The applicant should carefully read the statements in Boxes 24, 25 and 26 and tick the appropriate boxes. They must then choose and complete all following sections according to their branch of service and sign the form.

The complete Army DA 61 form together with all related documents should be submitted to a unit commander. The date they receive your paperwork is considered as the application submission date.

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