Af Form 2030 Usaf Drug And Alcohol Abuse Certificate printable pdf download

USAF DRUG AND ALCOHOL ABUSE CERTIFICATE

PRIVACY ACT STATEMENT

AUTHORITY: Title 10 U.S.C., Chapter 31, Sections 504, 505, 508, 513; Chapter 807, Section 8067; Chapter 833, Section 8258; Chapter 1205, Sec12201,

and Executive Order 9397 (SSN), as amended.

PURPOSE: To determine enlistment/commissioning eligibility, and process qualified applicants. To determine classification and assignment actions

after enlistment or commissioning. All documents are source documents in determining benefits/entitlements.

ROUTINE USES: Disclosures generally permitted under 5 U.S.C. 552a(b) of the Privacy Act outside the DoD as a routine use. 'Blanket Routine Uses'

apply.

DISCLOSURE: Voluntary; however, failure to furnish personal identification information my negate the enlistment/commissioning application.

SECTION I. DEFINITION OF TERMS

ADVERSE ADJUDICATION: An adverse adjudication (adult or juvenile)

is a finding, decision, sentence, or judgment, other than unconditionally dropped,

dismissed, or acquitted. If the adjudicating authority places a condition or restraint that leads to dismissal, dropped charges, or acquittal, the adjudication

is adverse. Suspension of sentence, pardon, not processed, or dismissal after compliance with imposed conditions is adverse adjudication.

AIR FORCE: Includes active Air Force, Air Force Reserve, Air National Guard, and Air Force Academy.

ALCOHOL ABUSE:

Alcohol use confirmed by competent medical authority that the individual is emotionally, mentally, or physically dependent on alcohol.

NOTE: When not confirmed by medical authority, self-admitted alcohol use that leads to a person's misconduct or unacceptable behavior; to the

impairment of work performance, physical or mental health, financial responsibility or personal relationships; must be reported during the medical

examination for determination of alcohol abuse.

DRUG ABUSE: The illegal, wrongful, or improper use of marijuana, any narcotic substance, hallucinogens, or any illegal drug.

Any drug or narcotic that is habit forming or has a potential for abuse because of its stimulant, depressant, or hallucinogenic effect.

ILLEGAL DRUGS:

Includes, but not limited to: cocaine, crack, hallucinogens,

(to include lysergic acid diethyamide (LSD), phencyclidine (PCP), tetrahydrocannabinal (THC)

in non-marijuana form, and others),

opium, morphine, heroin, dilaudid, codeine, Demerol, inhalants (paint, glue, and others) , amphetamines (speed),

methamphetamines (ice), barbiturates (downers) and anabolic steroids.

MARIJUANA: Any intoxicating organic or synthetic cannabis or tetrahydrocannabinal (THC) type substance. Organic forms from the hemp plant include

marijuana, hashish and all derivatives of cannabis sativa. Synthetically, in the form of an herbal and chemical product which, when consumed mimics the

effects of cannabis, includes salviadivinorum or salvinorum or any product known under such names as "Spice", "Genie", "DaScents", "Zohia", "K-2", and

"KO Knockout 2" or variant thereof by whatsover name it may be called.

SECTION II. CERTIFICATION AT TIME OF APPLICATION

WARNING: YOU MUST BE TOTALLY HONEST IN COMPLETING THIS FORM.

If you are truthful now and are accepted by the Air Force, no punitive

action can or will be taken against a civilian applicant as a result of any information you reveal.

HOWEVER, YOU ARE CAUTIONED THAT SHOULD YOU

CONCEAL DRUG OR ALCOHOL ABUSE INFORMATION AT THIS TIME, AND IT IS DISCOVERED AFTER YOUR ENTRY INTO THE AIR FORCE,

Such action includes, but is

PUNITIVE ACTION MAY BE TAKEN AGAINST YOU BASED UPON THE FALSE INFORMATION YOU HAVE PROVIDED.

not limited to, elimination from training or discharge under less than honorable conditions.

INITIAL YES/NO BOXES AS APPLICABLE

YES NO

I have read and understand the definition of the terms above.

Have you ever used or experimented with marijuana?

(Prior marijuana use is not disqualifying for enlistment or appointment, unless you are

determined to be a chronic user or psychologically dependent, have been convicted or adversely adjudicated for marijuana involvement.

Preservice marijuana use may render you ineligible for certain skills.)

Have you ever experimented with, used, or possessed any illegal drug or narcotic?

Have you ever been a supplier or distributor of or a trafficker in marijuana, or other illegal drugs or narcotics?

Have you ever been treated or undergone rehabilitation for drug or alcohol abuse?

Have you consumed hemp seed oil or any products containing hemp seed oil in the last 45 days?

INITIALS

SECTION III. STATEMENTS OF UNDERSTANDING

During my medical examination I will be tested and screened for drug and alcohol abuse. I understand that any detection of drug use

(including marijuana)

or alcohol abuse will render me ineligible for the Air Force. I understand I will undergo further drug and alcohol screening

after entry in the Air Force, and I may be discharged based on the results of such screening.

Service in the United States Air Force places me in a position of special trust and responsibility. Drug or alcohol abuse after this date will be

considered evidence of my inability to meet the standards of behavior expected of me as a member of the Air Force. Therefore, any drug use

(including marijuana) or any alcohol abuse as described above, FROM THIS DATE FORWARD,

renders me ineligible for the Air Force.

Drug and alcohol abuse by members of the U.S. Air Force violates Air Force standards of behavior and conduct and will not be tolerated. If I

am identified as a drug or alcohol abuser while a member of the Air Force, appropriate disciplinary or administrative action may be taken

against me, to include trial by court martial or discharge under less than honorable conditions.

I understand that certain skill areas in the Air Force cannot be performed by persons who have abused drugs or alcohol. My unit commander

will have final approval authority regarding my actual assignment to sensitive skill positions. If I am not acceptable for such duties due to

information I have revealed on this form, I will be reassigned to another position in my skill or reclassified into another skill. If it is established

that I have used any substance beyond that which I have indicated on this form, I understand my enlistment, commissioning, or appointment

may be declared fraudulent and I may be discharged.

KNOWING AND UNDERSTANDING ALL THE INFORMATION ABOVE, AND REALIZING THAT THIS DOCUMENT WILL BE USED ONLY TO

DETERMINE MY ELIGIBILITY AND RECORD MY CERTIFICATION OF ELIGIBILITY, I HEREBY STATE THAT THE ABOVE INFORMATION AS TO MY

PREVIOUS DRUG OR ALCOHOL INVOLVEMENT IS TRUE AND COMPLETE TO THE BEST OF MY KNOWLEDGE.

DATE

SIGNATURE

NAME (Last, First, M.I.) AND SSN OF APPLICANT

AF FORM 2030, 20121107

PREVIOUS EDITIONS ARE OBSOLETE

PRIVACY ACT INFORMATION: The information in this form is

FOR OFFICIAL USE ONLY. Protect IAW the Privacy Act of 1974