Niagara University ROTC

Last Name:        

First Name:             MI:   

Address:                      

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State:    Select state of residence ALABAMA ALASKA ARIZONA ARKANSAS CALIFORNIA COLORADO CONNECTICUT DELAWARE DISTRICT OF COLUMBIA FLORIDA GEORGIA GUAM HAWAII IDAHO ILLINOIS INDIANA IOWA KANSAS KENTUCKY LOUISIANA MAINE MARYLAND MASSACHUSETTS MICHIGAN MINNESOTA MISSISSIPPI MISSOURI MONTANA NEBRASKA NEVADA NEW HAMPSHIRE NEW JERSEY NEW MEXICO NEW YORK NORTH CAROLINA NORTH DAKOTA OHIO OKLAHOMA OREGON OVERSEAS OVERSEAS OVERSEAS OVERSEAS OVERSEAS PENNSYLVANIA PUERTO RICO RHODE ISLAND SOUTH CAROLINA SOUTH DAKOTA TENNESSEE TEXAS UTAH VERMONT VIRGIN ISLANDS VIRGINIA WASHINGTON WEST VIRGINIA WISCONSIN WYOMING      Zip Code:    -         

Sex:    Male    Female

Phone:        Phone#2:   

Email:   

Date Of Birth:    January February March April May June July August September October November December 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999

Present Status:    Freshman     Sophomore    Junior    Senior    Graduate Student  

Current Level of Education:    High School    College     Graduate School

Current College:    Not Applicable Canisius College University of Buffalo Niagara University Buffalo State College D'Youville College Daemen College Erie Comm. College Medaille College Hilbert College Niagara Cnty. Comm. College Other    

If Other:   

Number of Credits Earned:         Current GPA:  SAT/ACT:     

Major:    

Prior Service:    Yes     No         Years on Active Duty:    None Less then 1 1 2 3 4 5 6 7 8 9 10 or more     

Years in Reserves:    None Less then 1 1 2 3 4 5 6 7 8 9 10 or more

Current Unit of Assignment:   

I am interested in the following:

                Army ROTC Scholarships     More information about Army ROTC   

                Earning a Commission            Career Opportunities            

                Adventure Training                                    

                Please send me more info about:   

Please tell us specifically what information you would like to know about NU ROTC and please tell us a little bit more about yourself.