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Current Mailing Address
Date of Birth (mm/dd/yyyy)
Place of Birth
If Naturalized, give date, place, court jurisdiction and certificate number
Name and Address of Parent or Guardian
Name and Address of High School
Type of High School
Have you attended College or University?
Will you be attending UMD-College Park for the Fall 2016 Semester?
Are you a recipient of a National NROTC Scholarship?
Desired or Selected NROTC Program Option
Which Warfare Community do you wish to commission into?
Explosive Ordnance Disposal
If you have attended College or University (or have AP credits), how many credits do you have?
List your SAT Reading or ACT English Score
List your SAT Math or ACT Math Score
Indicate Intended UMD Major
Height (in inches)
Weight (in pounds)
Did you participate in JROTC?
Are you a military dependent?
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