Sex:
MaleFemale

First & Middle Name:
**Required Field

Last Name:
 (No dashes or hyphens, use a space)**Required Field

Suffix:
I II III IV V VI VII JR SR

Street or PO Box or RFD: 
**Required Field

City:
**Required Field

Select State Alabama Alaska American Samoa Arizona Arkansas Armed Forces Europe Armed Forces Pacific Armed Forces The Americas California Canal Zone Colorado Connecticut Delaware District Of Columbia Federated States Of Microne Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Marshall Islands Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Northern Mariana Islands Ohio Oklahoma Oregon Palau Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming

Zip Code:
**Required Field

Social Security Number:
 (No dashes or spaces)**Required Field

Date of Birth:
(mmddyyyy)  **Required Field 

Email:

Phone Number:
 (No dashes or spaces)

How did you first learn about registration?:

Advertisement Coaches/Counselors Community (organization, public event, school etc.) Direct Mail Driver’s Licensing Office Financial Aid Office/College/University Internet/Social Media Outreach Event **Required Field

  

SSS FORM 1, OMB APPROVAL 3240-0002

We estimate the public reporting burden for this collection will vary from two minutes per response, including time for reviewing instructions, searching existing data sources, gathering data, and completing and reviewing the information. Send comments regarding the burden statement or any other aspects of the collection of information, including suggestions for reducing this burden to: Selective Service System, SSS Forms Officer (3240-0002), Arlington, VA 22209-2425. The OMB control number 3240-0002, is currently valid. Persons are not required to respond to this collection unless it displays a valid OMB control number.