Army ROTC Interest Form
 
Last Name First Name Middle Initial
 
Street / P.O. Box City
 
State Zip Code
 
Home Phone Cell Phone What is the best way to contact you?
 
E-mail Age Date of Birth (dd/mm/yyyy)
 
Fall
Spring
Summer      
Current School Year Level I plan to enter MSU: Major
 
Next Semester (Fall or Spring)
Beginning Cumulative Credit Hours		 Current GPA (4.0 scale) Able to swim?
 
 
JROTC? If yes, how many years? Which program are you interested in?
 
Extra-Curricular Activities (Sports and Clubs):
 
What is your goal once you graduate from MSU?
 
What specific questions do you have?
 
 
How did you hear about the
MSU ROTC program?
 
--PRIOR SERVICE ONLY--
 
Current Unit Unit Phone Number Unit Clerk
 
City State Zip Code
 
Pay Grade MOS/Duty