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  Army ROTC

Forms 

Basic Course (Initial Enrollment Forms) - These forms are to be filled out by applicants that are seeking to contract and/or seek a scholarship. They are to be submitted in person, at our offices.

  • CC Form 139-R - Cadet Enrollment Record (Excel)
     
  • CC Form 136-R - Briefing of Government Benefits (PDF)
     
  • CC Form 137-R - Release of Student Records (Excel)
     
  • DA Form 3425-R - Medical Fitness Statement (PDF)
     
  • CC Form 104-R - Academic Alignment Sheet (Excel)
     
  • DD Form 2005 - Privacy Act Statement - Health Care Record (PDF-Fillable)
     
  • SF86 - Security Clearance Application (PDF)
     
  • SF1199 - Direct Deposit Form (PDF)
     
  • *DA Form 4824-R - Simultaneous membership program agreement for Army Reservists.  This must be submitted to us if you elect to do the SMP program with the USAR (PDF).
     
  • *DA 594-1R -  Simultaneous membership program agreement for Army National Guard Cadets.  This must be submitted to us if you elect to do the SMP program with the National Guard (PDF).

*Not required for those planning on becoming Active Duty Army Officers.

Advanced Course Forms (Contracting Forms) - These forms are to be filled out after you have completed and submitted the basic course forms.  These are not required for initial enrollment.

  • DA Form 597 - Cadet Non-Scholarship Contract. Non-scholarship cadets need to read this thoroughly prior to contracting (PDF)
     
  • DA Form 597-3 - Cadet Scholarship Contract. Scholarship cadets need to read this thoroughly prior to contracting (PDF)
     
  • DD Form 4 - Enlistment Document. All contracting cadets need to read this thoroughly (PDF-Fillable)
     
  • DD Form 93 - Record of Emergency Data (PDF-Fillable)
     
  • DD Form 2351 - DoDMERB Medical Examination Form (PDF-Fillable)
     
  • DD Form 2492 - DoDMERB Medical History Form (PDF-Fillable)
     
  • SGLV 8286 - Soldier's Group Life Insurance Form (PDF-Fillable)
     
  • W-4 - Employee Withholding Allowance Certificate (PDF-Fillable) 

 


 
 

 

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