MIZZOU NROTC INFORMATION REQUEST

THIS FORM COMES UNDER THE PURVIEW OF THE PRIVACY ACT OF 1974

All fields on this form are optional, however, the more information you provide, the better we will be able to assist you.
STUDENT INFO
 
FIRST & LAST NAME E-MAIL ADDRESS
 
STREET ADDRESS
PHONE # / TYPE
 
 
CITY/STATE/ZIP
DATE OF BIRTH
 
 
HIGH SCHOOL ACADEMICS
 
HS NAME
HS GRAD DATE
 
HS GPA / SCALE
/ (ex. 3.28 / 4.0)
ACT SCORES
COMP MATH ENGL
 
HS STANDING
/ (ex. 18 / 250)
SAT SCORES
MATH READ WRITING
 
MIZZOU ADMISSION STATUS

APPLIED? YES NO

INTENDED MAJOR
ACCEPTED? YES NO
 
NROTC SCHOLARSHIP APPLICATION STATUS

APPLIED? YES NO IN THE PROCESS

    
STATUS? APPROVED DECLINED PENDING  
 
COMPLETE THIS SECTION IF YOU ARE ALREADY IN COLLEGE
 
COLLEGE NAME
YEAR / CREDITS
 /
 
CUMULATIVE GPA
EXP. GRAD DATE
 
INFORMATION REQUESTED (Check all that apply)
 
I would like to apply for the 3-4 year College Program. Please send me the username and password to access the application.
 
Navy-Option Marine-Option Nurse-Option
 
4 Year Scholarship 2 Year Scholarship Tweedale Scholarship
 
4 Year College Program 3 Year College Program 2 Year College Program
 
Physical Training Requirements Academic Requirements Extracurricular Activities
 
Job Options After Commissioning Service Commitment After Commissioning
 
For additional information requests, use the comment block below
 
QUESTIONS / COMMENTS