Texan Battalion - Tarleton State University

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Last Name:	First Name:
Email Address: (ex: rotc@tarleton.edu )
Address:	City:
State:	Zip Code:
Phone Number:	Can we contact you via email? Yes No

Military Experience

Prior Military Service: Active Duty Reserves National Guard JROTC

Rank:

Service:

Attended Basic:
Yes No

AIT:
Yes No

Current/Last Unit Assigned:

Location:

High School Information

High School Name: GPA:
High School Graduation Date:		ACT Score:
College Hours Earned in High School.:		SAT Score:

College Information

College/University Attending: GPA:
Projected College Graduation Date:	Academic Classification:
Academic Major:	Credit Hours Earned:
Projected TTU Enrollment/Return Date:	Hours Currently Enrolled:

Planning to Attend - Top Three Schools

Extra-Curricular Activities: (list leadership positions held)

Interested in the following (check all that apply)

	ROTC SCHOLARSHIPS		ACTIVE DUTY COMMISSION
	TWO YEAR PROGRAM		RESERVE DUTY COMMISSION
	THREE YEAR PROGRAM		RESERVE/NATIONAL GUARD BENEFITS
	FOUR YEAR PROGRAM		SIMULTANEOUS MEMBERSHIP PROGRAMS
	LEADER'S TRAINING COURSE (Sophomores)		ARMY NURSING
	ADVENTURE TRAINING (Airborne, Air Aslt., etc.)		ROTC EXTRA-CURRICULAR ORGANIZATIONS

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