| Full Name: |
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| Phone: |
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| E-mail: |
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If National Guard or USAR
MOS:
Unit: |
Major:
College: |
Interest
General ROTC
Nursing
Science/Engineering |
Minimum Requirements
- Must be a full-time student
- Age
- Must be 17 when you start (Not Waiverable)
- No older than 39 when you commission (Waiverable)
- No record of disciplinary problems or civil convictions (Waiverable)
- Must be a US Citizen or US National
- Dependents
- If single, must have no legal dependents
- If married, cannot have more than 3 dependents (Waiverable)
- Must be able to pass a standard sports physical
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| General |
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| How old are you? |
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| Are you a US Citizen or US National? |
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| Are you married or single? |
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| Do you have any legal dependents? |
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| Have you ever been arrested or convicted of a crime? |
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| Scholar |
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| Are you a full-time student? |
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| What academic year are you? |
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| What is your GPA? |
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| What is you ACT/SAT score? |
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| Are you a member of any Honors Society? |
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| Are you an Honors/AP Student? |
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| Athlete |
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| Have you ever been a member of a HS, city, region, or organized sport? |
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| What sport(s) did you play? Were you a Captain? |
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| Can you swim? |
Yes
No |
| Do you have any prior or existing medical conditions? (i.e. asthma, broken bones, major surgery, torn ligaments, allergies, etc.) |
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| Leader |
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| Were you an Eagle Scout? |
Yes
No |
| Were you an elected member of a student organization? |
Yes, if so which organization:
No |
| Did you hold any other positions of responsibility in a club/organization? |
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| Did you do JROTC? If so, how many years? |
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| Any other leadership positions (work, clubs, church groups, etc) |
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| General Notes (About yourself, your interest in ROTC, and how you heard about us) |
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