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Forms needed for Enrollment

Forms needed for Enrollment

Form required in order to enroll in the program

Forms	Descriptions	Remarks	Directions
1	139 R	Cadet Enrollment Record	Must be typed; fill out pages 1 and 2 only.

Additional Documentation and Forms to be hand-carried to NCO

Forms	Descriptions	Remarks	Directions
2	DA Form 3425-R	Physical Exam Form	Must be filled out by a Doctor, PA or Nurse. Can be hand-written and scanned.
3	CC Form 136-R	Briefing on Government Sponsored Benefits	Can be hand-written, print it out, sign/date.
4	CC Form 137-R	Authorization for Access to Student Records	Part one must be signed to access your transcripts and to speak with your parents about your academics. Type in your name, school, and parent's names then print it out, sign/date. **IF YOU DO NOT WISH FOR US TO SPEAK WITH YOUR PARENTS - SIGN/DATE PART II.
5	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. This is not a requirement for New Cadet Orientation -- you will complete when you arrive on campus prior to contracting.
6	DD Form 93	Record of Emergency Data	Must be typed, sign in block #15. Do not fill in block #16. Cadre will do that on campus.
7	DD Form 2005	Privacy Act Statement Health Care Records	Can be hand-written, print it out, sign/date.
8	Proof of Health Insurance	ID Card or Paperwork	Copied and returned to student immediately.
9	Transcripts	High School and/or College	Unofficial is acceptable; must have name/address on form.
10	Contracting Memorandum Of Understanding	Contracting Memorandum of Understanding	Print, initial and sign.
11	DD Form 2058	State of Legal Residence	Can be hand-written, print it out, sign/date.
12	SGLV 8286	Service Member's Group Life Insurance Form	Must be typed, print it out, sign/date.
13	SF 1199A	Direct Deposit Form	Must be typed, print it out, sign/date, leave section 2 blank, ***AND bank must fill out section 3.
14	W-4 2023	Tax Form	Must be typed, print it out, sign/date.
15	SSN Card and Photo ID or Driver's License	Must be original	Copied and returned to student immediately.
16	Dental Record Memo	Statement of Acknowledgement	This form is to confirm the existence of dental records. Can be hand-written. No need to make a dental appointment.
17	Birth Certificate	Must be original or certified copy	Copied and returned to student immediately.
18	Standardized Test Scores	Documentation from ACT or SAT	Unofficial is acceptable; must have name/address on form.

The following are copies of ROTC Contracts and Security Clearance Forms

Forms	Descriptions	Remarks	Directions
19	SF-86	Security Clearance Questionnaire	Do Not fill out
20	DD Form 4	Enlistment Document	Do Not fill out
21	DA Form 597	ROTC Scholarship Cadet Contract	Do Not fill out
22	DA Form 597	ROTC Non-Scholarship Cadet Contract	Do Not fill out