Department of Military Science and Leadership
Army ROTC
1 University of Arkansas
Fayetteville, Arkansas 72701-1201
(479) 575-4251 or (toll free) (866) 891-5538

Privacy Act Notice:
Disclosure of any information by you is strictly voluntary. However, delays in providing you requested materials may result by not providing complete information. All information collected will be used strictly for recruiting purposes. The authority for the collection of this information is Title 10, United States Code, Section 503.

Name: 
E-mail Address: 
Address: 
Phone Number: 

 Age:  
Gender:

ACT/SAT Score (combined): 
GPA: 
Interests: 

Major:

High school currently Attending:

University currently Attending:

I would like more info about: 
Scholarships 
ROTC Program 
Green to Gold 
Nursing 

What is your current educational level or occupational status?

Additional Comments: 
Department of Military Science and Leadership
Army ROTC
1 University of Arkansas
Fayetteville, Arkansas 72701-1201
(479) 575-4251 or (toll free) (866) 891-5538