ROTC Enrollment Packet

The seven documents listed below must be completed if the student wants to partake in the extra curricula activities associated with ROTC, such as: Physical fitness training, leadership labs, and Field Training Exercise (FTX) which include rifle ranges, land navigation training, obstacle courses, and leader reaction courses.

1.  Proof of Citizenship – Students must provide official documentation demonstrating that they are a citizen of the United States.  This can be completed by producing either a U.S. Birth Certificate or unexpired U.S. Passport.

2.  Social Security Card – Students must provide official document for verification by ROTC Cadre.

3.  CC 139-R – (Right click and “Save As”) This is a cadet enrollment record form. This form is fillable, DO NOT hand-write your information on this form. The form has 6 pages; however, only the first 2 pages need to be completed for contracting purposes. The following is a list of items that may help you when filling out the form:

  • Block # 9: DOB – Date of Birth
  • Block # 10: POB – Place of Birth
  • Block # 24: Next of Kin – Who would we contact in an emergency
  • Block # 25a / 26a: FICE code – Do not fill this in
  • Page #2: Initial one box in each section (blocks #42-46).
  • You must sign page #2 where is states “All information given on this form is correct to the best of my knowledge.”

4.  CC 137 – Authorization for access to student records.

  • Fill out part 1 if you would want to authorize an ROTC instructor to speak with your parents about your performance, to include grades, should they contact us.
  • Fill out part 2 if you do not want us to discuss your performance with your parents/legal guardian.

5.  CC 136 – Government Sponsored Benefits for ROTC Cadets.  Sign and date the bottom of the form.  This indicates that you have read and understand the information on the form.

6.  DA form 3425-R – Medical fitness statement.  Go to your physician and have that physician fill out this form saying you have no medical conditions or physical impairments that may hinder your participation in ROTC.

7.  DD 2983 – Recruit/Trainee Prohibited Activities Acknowledgment. Complete blocks 1-9 only.