Preliminary Application Form: Federal Bureau of Prison Registrar Program
All men ages 18 - 25 trying to register with Selective Service please click   here.

Federal Bureau of Prisons and the Selective Service System (SSS) insure that a warden at each institution nominates at least two employees as a primary and alternate Selective Service Registrar to help eligible men register with Selective Service when released (more)

Must enter or select (*) fields.
Last Name *   First Name *  
M.I. Gender *  
Title Email *    
Business Name*  
Address *  
City*   State*  
ZIP Code *      
Phone (xxx-xxx-xxxx) Fax (xxx-xxx-xxxx)
If you are a male, did you register with Selective Service? *

Are you a U.S. Citizen? *