THE ARMY RESERVE OFFICERS' TRAINING CORPS (ROTC) CAMPUS-BASED SCHOLARSHIP PROGRAM

Step 1:  Read and complete the Scholarship Application and gather required documents.

Step 2:  Contact the Human Resources Technician at 719.262.3520 to schedule an eligibility interview.

Step 3:  Complete a DoDMERB physical.

Step 4:  Sign a ROTC Cadet Contract.

IT IS YOUR RESPONSIBILITY TO ENSURE THAT YOUR APPLICATION IS COMPLETE AND RETURNED TO:

University of Colorado at Colorado Springs, C/O Department of Military Science, ATTN: Recruiting Operations Officer, 1420 Austin Bluffs Parkway, Colorado Springs, CO 80918  

APPLICATION PROCEDURES 
CHECKLIST
INSTRUCTIONS FOR COMPLETING CC Form 139-R
LIST OF APPROVED ACADEMIC DISCIPLINES

APPLICATION PROCEDURES   

Read instructions carefully.  Print or type the information required.  Incomplete or inaccurate forms may eliminate you from further scholarship consideration.  It is your responsibility to ensure that all required forms are submitted to:

University of Colorado at Colorado Springs, C/O Department of Military Science, ATTN: Recr uiting Operations Officer, 1420 Austin Bluffs Parkway, Colorado Springs, CO 80918

Contact the Recruiting Operations Officer at 719.526.3475 or rotcroo@uccs.edu for further information.  Incomplete files will not be considered by the scholarship Selection Board for review.  NOTE:  RETAIN A COPY OF ALL PAPERWORK FORWARDED FOR YOUR RECORDS.

Your completed application will consist of the following:  (NOTE:  See “Application Checklist”)

        a.  Cadet Command Form 139-R (Cadet Enrollment Record).  If your answer to civil conviction is yes YOU MUST REQUEST A WAIVER OF THE DISQUALIFICATION.  The waiver request must be submitted with your application.  Include a complete written description of the offense, to include all circumstances leading up to arrest and conviction and complete sentence imposed, copy of the court record which indicated the charge, plea, and/or findings, as well as the sentence imposed and the record showing satisfaction of the sentence (when court records are not available this fact must be established by correspondence from the court), and three recent letters of character reference which indicate that the writer is aware of your specific situation requiring a waiver.  Your statement must be certified under oath.  If you decline to answer the civil conviction statement you will not be considered for a scholarship.  If an offense occurs after you submit your application up to the date of discharge you must also inform this headquarters and request a waiver.

        b.  Cadet Command Form 103-R (Active Duty/Reserve ROTC Scholarship Applicant Snapshot).  Affix a recent (within the last 3 months) photograph, which will be retained by this headquarters.  Print your name and social security number on the back of the snapshot or photograph and on the form.

        d.  Medical Examination.  Your medical examination is scheduled once your eligibility is verified.  The medical forms that must be used for your physical are on the Scholarships Forms page.  Medical examinations must be submitted by the examining facility as soon as possible to:  DoDMERB, 8034 Edgerton Drive, Suite 132, USAF Academy, CO 80840-2200.  DODMERB will not process and return any physicals not on these forms.  If any additional tests or evaluations are required for final medical determination, DODMERB will return the packet to you at your university ROTC detachment.  DODMERB will return the completed physical to your university ROTC detachment You must be fully medically qualified PRIOR to contracting.  DO NOT SEND THE PHYSICAL TO DODMERB YOURSELF.  Delay in forwarding physical could result in not being medically qualified in sufficient time to be contracted and begin receiving scholarship benefits.  The physical qualification process normally takes DODMERB anywhere from 6-8 weeks from start to finish.  Any remedial or follow-up required by DODMERB should be accomplished by you prior to contracting.

        e.  Official transcripts of all colleges you have attended.  The selection board will not consider application files with partial transcripts.  The school accepting you for attendance should establish a grade point average (GPA).  However, if the school does not establish GPA then the GPA from your latest complete transcript will be used.  If you have received college credit by means of the USAFI or CLEP tests, official results of such tests must also be furnished to your university ROTC detachment.  College Grade Reports are not transcripts and are unacceptable.  High school transcripts are required for individuals applying for a 4-year scholarship.

        f.  Results of Scholastic Aptitude Test (SAT) or the American College Test (ACT).  Applicants must achieve a minimum SAT score of 920 (composite of Verbal and Math) or an ACT composite score of 19 to qualify for competition.  If you take both the SAT and ACT furnish the results of both tests to your university ROTC detachment.  Results must be received prior to consideration for scholarship award.  Any other College Board tests taken other than ACT or SAT are unacceptable (e.g. CEEB, etc).

        g.  Letter of Acceptance.  Obtain a letter of acceptance from an accredited baccalaureate degree producing college or university offering Army ROTC indicating your status as an academic freshman, sophomore or junior.  For the 2- and 3-year scholarship, if you are undergoing academic studies and have not attained sophomore or junior status (whichever is applicable) at the time of application to a school, the letter may state that you are conditionally accepted pending final completion of current studies.  A follow-up letter and Cadet Command Form 104-R indicating your status will be required prior to award of a scholarship.  If you are applying for a graduate degree your letter of acceptance must be from an accredited masters degree producing program.

        h.  Planned Academic Program Worksheet (ROTC Cadet Command Form 104-R).  If applying for a scholarship, the university’s academic counselors must complete the CC Form 104-R indicating your academic status.  (Example:  If you are applying for a 2-year and your intended major is Nursing, the 104-R must be from the School of Nursing.)  The Professor of Military Science at the institution you plan to attend will assist you in the completion of this form.  If the school you plan to attend does not host Army ROTC, please have the school official forward the form to the Army ROTC host institution with which a partnership school agreement in ROTC is authorized.  Verification form must indicate you have been accepted in the academic discipline that you indicate you will pursue.  Scholarship recipients must attend the institution that provides the Form 104-R.  Recipients who desire to attend a school other than the one which provided the initial 104-R must submit a subsequent 104-R verifying your academic status, letter of acceptance from the college/university, and the letter of acceptance from the PMS to this headquarters for approval prior to accepting the award and discharge.  This form must be signed and authenticated by the student and the registrar.  Cadet Command Form 104-R containing summer sessions will not be accepted.  Scholarships are awarded to the school you applied to and cannot be used at any other school.

        i.  Evaluation of Transfer of Credit.  If you will be attending a college/university other than the one from which you obtained your college credits, an evaluation of transfer of credits is required.  Evaluation should include course number and title, course grade, credit hours attempted and earned toward the degree pursuing and grade point average if available.

        j.  Copy of waiver request (dependency, civil convictions, etc) if applicable.  Contact the Human Resources Technician at 719.262.3520 for assistance in completing waiver requests.

        k.  Social Security Card.  Provide certified copy of your Social Security Card.  The Human Resources Assistant can make a certified copy of your original.

        l.  Birth Certificate.  Provide certified copy of your Birth Certificate.  The Human Resources Assistant can make a certified copy of your original.

       m.  Department of Defense Form 214.  If you ever served in the military please provide a copy of your DD Form 214.

Should you have questions or desire assistance in completing your scholarship application, you may contact the Recruiting Operations Officer at the University of Colorado at Colorado Springs at 719.262.3475 or rotcroo@uccs.edu.  

NOTE:  Should you have any change in status (address, dependency, marital, civil conviction, pregnancy, etc.) from the time you apply for a scholarship until notification of awards and discharge, you must inform this headquarters.

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CHECK LIST

Prior to mailing ensure the following are in order (Please no binders or document protectors.  Use pocket folders or manila folders)--

________CC Form 139-R (Cadet Enrollment Record)  (Complete)         

________Medical Examination

        o  Within the last six months
        o  DD Form 2351 (Report of Medical Examination)
        o  DD Form 2492 (Report of Medical History)
        o  DD Form 2372 (Statement of Present Health)

________Official Transcripts

        o  Transcripts from all previous colleges attended
        o  Verifies minimum 2.5 GPA
        o  High School transcript (4-year only)

________SAT/ACT Test Results

        o  All applicants  

________Acceptance Letter 

        o  Letter must be from university in which you will enroll indicating your status as a freshman, sophomore or junior

________Evaluation of Transfer of Credit

        o  Form must be from the university you will attend
        o  Form must provide academic status and hours accepted toward degree pursuing

________CC Form 104-R (Planned Academic Program Worksheet)

        o  Form must be from the university you will attend
        o  Verified, signed and dated by the student and Registrar

________Acceptance letter from the Professor of Military Science (PMS)

         o  Letter must be from the PMS, Army ROTC, indicating your acceptance into the program

________Letter Outlining SAL Attributes as outlined in the Eligibility section

________Copy of waiver request if applicable

________CC Form 228-R (Financial Statement)

________CC Form 137-R (Authorization for Access to Student Records)

________CC Form 133-R (Privacy Act Statement)

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INSTRUCTIONS FOR COMPLETION OF CC FORM 139R

Part 1:  General Information  

In the top right corner put your eye color/hair color in Pen.

 Part 2:  Academic Information

Part 3: Current/Prior Military Service or Officer Producing Program

Part 4:  Student Statements  

At the top right side of page 2 print your last name and social security number.  (Pen)

Read each block of information.  Initial the box that applies to you. (Pen)

Your signature and date (DD, /MM/YY) at the bottom of page 2 of 6 (two places require your signature and date). (Pen)