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TEXAS NATIONAL GUARD APPLICATION FOR EMPLOYMENT/PROMOTION
INFORMATION LISTED BELOW IS IN ADDITION TO INFORMATION REQUIRED ON OF 612 OR RESUME
LAST NAME
FIRST NAME
MIDDLE NAME
DATE
POSITION TITLE
ANNOUNCEMENT NUMBER
CURRENT MILITARY MEMBERSHIP
RANK
UNIT OF ASSIGNMENT
TXARNG
TXANG
OTHER*
NONE
*Specify in Remarks
SSI/MOS
AFSC
PSSI/MOS
DSSI/MOS
PAFSC
DAFSC
TITLE
TITLE
2AFS
3AFS
MILITARY SERVICE:
# Indicate “A” for Active Duty “R” for Reserve
FROM
TO
POSITION & GRADE
#
UNIT OF ASSIGNMENT
LOCATION
MILITARY SERVICE SCHOOLS:
FROM
TO
TITLE OF COURSE
LOCATION
BRANCH OF SERVICE
REMARKS (ADDITIONAL SSI/MOS/AFSC):
THIS STATEMENT MUST BE SIGNED
Read the following statement carefully before signing this Statement
A false statement on this form may be grounds for dismissal, and may be punishable by fine or imprisonment (U.S. Code, Title
18, Sec. 1001). All information given will be subject to investigation.
SIGNATURE (Sign in Ink)
DATE SIGNED
CERTIFICATION
I CERTIFY that the statements made in
this supplement are true, complete, and
CURRENT HOME ADDRESS AND ZIP CODE
correct to the best of my knowledge and
belief, and are made in good faith.
JFTX-J1-HR Form 5
(Revised October 2005) – See Reverse for Privacy Act Statement. Previous editions may be used until
stock is exhausted.

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