ENROLLMENT/CONTRACTING

Minimum Requirements for Enrollment in the Program

The documents listed below must be completed if the student wants to partake in the extra curricular activities associated with ROTC, such as: Physical Training (PT), leadership labs, and Field Training Exercise (FTX) which include rifle ranges, land navigation training, obstacle courses, and leader reaction courses. For a guide to help with the completion of the contract package, please see slideshow below, or to download the same click here.

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ECLT (English Comprehension Level Test)

Minimum score of 60 points is required to join the program. The ECLT is given at ROTC Bldg, Rm 105.

Cadet Mini-Registration

This document provides HRA with the necessary information to being the enrollment process.

Host School will be UPR Mayaguez
FICE code is 003944.

DA 3425-R (Medical Statement for Enrollment)

Go to your physician and have that physician fill out this form stating you have no medical/physical conditions/impairments that may hinder your participation in ROTC.

Dental Exam Requirement Form

Need to know the location of your dental x-rays – for emergency purposes only. You are the person that signs this form. *Do not bring your dental x-rays*

USACC 139-R (Cadet Enrollment Record)

Block #9: DOB (Date of Birth)
Block #10: POB (State of Birth)
Block # 26: Next of Kin (parent, spouse or closest living relative) name and address.
Block # 25a / 26a: FICE code is 003944
Page 2: Initial one box in each section (blocks #42-46)
Sign page 2 where is states “All information given on this form is correct to the best of my knowledge.”

Birth Certificate, Social Security Card, and Immunization record (copies)

Students must provide copies, for verification by ROTC Cadre, demonstrating that they are a citizen of the United States. This can be completed by producing either a U.S. Birth Certificate or unexpired U.S. Passport. Immunization record can be found at Puerto Rico Immunization Registry website (https://prir.salud.gov.pr).

CC 136-R

Government Sponsored Benefits for ROTC Cadets. Sign and date the bottom of the form. This indicates that you have read and understand the information on the form.

CC 137-R Authorization/Declination for Access to Student’s Records

Fill out part 1 if you would want to authorize an ROTC instructor to speak with your parents about your performance, to include grades, should they contact us.
Fill out part 2 if you do not want us to discuss your performance with your parents/legal guardian.

Minimum Requirements for Conditional Contracting

Physical Exam

Scheduled in person with Mrs. Marti, Edibeth, DoDMERB coordinator.

If Prior Service, must have SMP agreement and provide:

DD 2807-1 – Record of Medical History
DD 2807-2 – Accessions Medical Prescreen Report
DD 2808 – Record of Medical Examination

*Current from MEPS*(less than 12 months old)

If contracted attending Basic Camp without qualified Dodmerb document must provide:

Safe to Train Physical

DA 705 ACFT (Army Combat Fitness Test) Scorecard

ACFT administered by ROTC Cadre. Minimum score of 60 points on each event required for contracting. For the ACFT scoring scale, click HERE

Documents Required for Contracting

In addition to the minimum requirements for enrollment, the following documents listed below must be completed to contract as an ROTC Cadet and receive Scholarship and/or Stipend.

Contracting Checklist

This is a checklist of every form needed in order to contract with the US Army ROTC program. Please use it to your advantage.

CC 104-R

Planned Academic Program Worksheet.

You ROTC instructor may advise you on the best method for getting this document completed.

Page 1 (1-7): completed by the Cadet and should contain all of the classes you need to complete your bachelor’s degree, as well as, all of the required ROTC classes.
Page 3: Fill name of university and degree type. Cadet signature and date at bottom.
Page 2, block # 12 must be signed by your academic advisor, acknowledging courses needed to complete your degree.

College Transcript, Copy; H.S. Transcript (2.5 term/cumulative GPA minimum)

For the direct deposit forms below, you can either fill out the FMS 2231 yourself or take the SF 1199A to be filled out and signed by a bank official at your banking institution.

FMS 2231 – Fast Track Direct Deposit

SF 1199A – Direct Deposit Sign-up Form

Section 1 (A, D, & E): completed by the Cadet and must sign first signature block in that section.
Section 3: Completed by the students bank official. Must have bank official’s signature.

Performance Counseling (IAW CC 145-1)

Record of Performance Counseling Session. Informing the cadet on the minimum expected performance to participate and stay in the program.

DD 2058

State of Legal Residence. Fill in name, SSN, and your legal mailing address. Sign and date the bottom (May have to download PDF to edit)

W-4 – Current Year Tax Form

Section 1: Provide your name and address.
Box 2: Provide your Social Security Number.
Box 3: check the box that corresponds to your marital status, single or married.
Line 5: total number of allowances you are claiming (page 3 for details).

SGLV 8286

Service members’ Group Life Insurance Election and Certificate. Fill out your personal information in section 1, elect if you want the life insurance, or want to reduce the amount in section 2, list your beneficiaries information and payment options in section 3, and sign and date and fill information in section 5. The additional forms are provided to ensure you understand the purpose and how to complete the form.