haʊˈɛvɚ, ɐpˈɔɪntmənts tə ðɪs ɡɹˈeɪd kæn biː mˌeɪd baɪ kəmˈɪʃən baɪ ðə sˈɜːvɪs sˈɛkɹətɹiz, dᵻfˈɛns sˈɛkɹətɹi, ɔːɹ ðə pɹˈɛzɪdənt, bˌʌt ðɪs ɪz mˈoːɹ ʌŋkˈɑːmən.
However, appointments to this grade can be made by commission by the service secretaries, defense secretary, or the President, but this is more uncommon.