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USA Army ROTC
Military Science Department
551 University Blvd., N., Room 124
Mobile, Alabama 36688-002
E-mail: gbr@usouthal.edu
Phone No. (251) 460-6341 or 800-252-4835 ext. 6341
Fill out the form below to request information on Army ROTC.

*Last Name

*First Name

*Address

*City

*State

*Zip

Home Phone

Cell Phone

*E-mail

Age

Height

feet inches

Weight

lbs.

Sex

Name of High School

High School Graduation Year

High School GPA

Junior College Name (if applicable)

College Credits Earned

College GPA

ACT Composite Score

SAT (Verbal & Math)

Have you applied for scholarships?

Select your college preference:

If you selected "Other," please specify:

List any sports played:

List any extracurricular activities:
(clubs, student government, etc.)

Prior Military Service (if applicable)

years months

Have you taken the ASVAB?

Have you taken a Military Medical Exam?

Do you have any medical condition(s) or are you taking any medication(s) that may prevent you from entering military service?

Are you a U.S. Citizen?

University of South Alabama - Mobile Alabama 36688-0002 (251) 460-6341
For questions or comments Contact Us
Date last changed: September 21, 2011 11:28
http://www.southalabama.edu/armyrotc/contact.html

University of South Alabama

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