Enrollment Forms
ROTC classes are a lot of fun...however, there is some paperwork before you get started. Some of these forms can be filled out
Fill these out prior to arrival
- Instructions to fill out forms
- DA 3425 Medical Fitness Statement (Only if you do not have a DoDMERB or MEPS Physical stamped qualified)
- CC Form 136-R: Briefing on Government Sponsored Benefits
- CC Form 137-R: Access to Student Records
- Dental Release Form
- State of Legal Residence Certificate
- SF 1199: Direct Deposit Sign-Up: We will need a voided check to the account you want your money deposited.
- DD 2005: Medical Privacy Act
- W-4: Federal Income Tax Withholding Form
- SF 86: Security Clearance Form Questionnaire This form must be filled out electronically. We can't accept a hand prepared copy.
Bring these documents with you
- Original Birth Certificate (It will be copied and returned to you.)
- Original Social Security Card (It will be copied and returned to you.)
- Copy of high school transcripts
- Copy of all college transcripts
- Proof of ACT/SAT scores
- Shot records with proof of MMR and Varicella vaccination (Chicken Pox) or proof that you had chicken pox from your doctor. This can be obtained with a simple blood draw.
Fill these out once you arrive
-
CC 104-R: Planned Academic Program Worksheet - ***Download or Save this form to your desktop PRIOR to filling out any fields in the CC104-R form to ensure that your information will be saved.***
- CC 104-R: Instructions
- Classification of Instructional Program (CIP) Codes (also can be found on the CIP User website).
- Xavier Supply Form
Fill these out at contracting
- SGLV 8286: Serviceman's Group Life Insurance: If you are in the Guard or the Reserves bring us the copy you have on record with your unit.
- DD 93: Record of Emergency Data: If you are in the Guard or the Reserves bring us the copy you have on record with your unit.