Enrollment Forms

Forms required in order to enroll in the program

(any Social Security Number can be left blank and filled out on-campus)

Forms

Descriptions

Remarks

Directions

1

CC Form 139-R

Cadet Enrollment Record

Fill out pages 1 and 2 electronically then print and sign on page 2.  You can leave the SSN blank and fill in upon arrival.

2

CC Form 136-R

Briefing on Government Sponsored Benefits

 
3

CC Form 137-R

Authorization for Access to Student Records

Part one must be signed to access your transcripts.

4

DD Form 93

Record of Emergency Data

 
5

DA Form 3425-R

Medical Fitness Readiness Statement

This allows you to participate in the physical fitness program.
6

Proof of Health Insurance

 

 

7 Transcripts High School or College Unofficial copy is acceptable.

Additional Documentation for Scholarship Recipients

8 Contracting Memorandum of Understanding

 

Contracting Memorandum of Understanding

Initialed and signed

9 DD Form 2058 State of Legal Residence Use your campus address as your "Current mailing address".
10 SGLI 8286 Service Member's Group Life Insurance Form This is provided free to the cadet. Your rank, title, or grade is "Cadet".
11 SF 1199A Direct Deposit This is required for your monthly stipend.
12 Form W4 2016 Employee's Withholding Allowance  
13

SSN Card and Photo ID

Bring them with you

 
14

Dental Record Memo

Statement of Acknowledgement

This form is to confirm the existence of dental records.

15

DD Form 2005

Privacy Act Statement Health Care Records

 
16

Birth Certificate

Must be original or certified copy.

This will be returned to the student.

17

Copy of Acceptance Letter

The acceptance letter to the university

 

Forms you will fill out on campus

18

SF 86

Security Clearance Questionnaire

This is a very detailed form that will simplify the online security process.

19

CC Form 104-R

Planned Academic Worksheet

This is your planned academic worksheet. Working through this sheet with your academic counselor will help ensure you graduate on time. Your instructor will help you fill this out.

Read-ahead forms for contracting

20

DA Form 4

Enlistment Document

Do not fill out

21

DA Form 597

ROTC Scholarship Cadet Contract

Do not fill out