Any questions please contact Ms. Maria Cavazos at (956) 326-2387 or fill our Army ROTC Request Form.

Name

Address

City State ZIP

Phone Birth Date (mm/dd/yy)

E-mail address

Can we contact you via e-mail? Yes No

U.S. Citizen? Yes No

Ethnic background (optional) Asian Native American Black/African American White/Caucasian Hispanic/Latino Other

I am most interested in: General ROTC Science & Engineering Nursing

I would like to receive a scholarship application.

High School graduation year (i.e., 1998)

College attending/planning to attend (Full name of college and state)

* The information you voluntarily provide, including your Social Security Number, will be used for recruiting purposes only. Your social security will be used to analyze individual response to the mailing.

(Authority: 10 usc 503)