Preliminary Application Form: High School Registrar Program
All men ages 18 - 25 trying to register with Selective Service please click   here.

A guidance counselor, teacher, and administrative staff member who represents their school as a Selective Service System Registrar to inform male students about the federal requirement to register with the Selective Service System and provides a convenient location and means to register at the high school. (more)

Must enter or select (*) fields.
Last Name *   First Name *  
M.I. Gender *  
Title Email *  
School Name*  
Address *  
City*   State*  
ZIP Code *        
Phone (xxx-xxx-xxxx) Fax (xxx-xxx-xxxx)
  School Type *

If you are a male, did you register with Selective Service? *

Are you a U.S. Citizen? *