Candidate Interest Form

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1. First Name:
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2. Last Name:
3. Date of Birth:
4. Age:
5. Sex:
6. Race:
7. Citizenship:
8. Address:
9. Phone Number where you can best be reached:
10. E-mail Address:
11. High School Attended, City, State:
12. Height in inches:
13. Weight in pounds:
14. Are you in a Delayed Entry Program or currently Active Duty Military?
15. Have you ever ran 1.5 miles? If so, what was your time?
16. Can you swim 50 yards without stopping?
17. High School GPA:
18. Class Rank (ex. 25 of 400):
19. Graduation Date (MM/YYYY):
20. SAT/ACT Composite Score:
21. SAT/ACT Math:
22. SAT/ACT Verbal:
23. If you participated in JROTC, what what the highest billet you held?
24. Please list any extracurricular activities you are involved in:
25. If you are enrolled in college what is your current GPA?
26. Please list the most advanced MATH and SCIENCE courses you completed in HIGH SCHOOL:
27. If you are enrolled in COLLEGE, please list the most advanced MATH and SCIENCE courses you have completed:
28. Which university are you interested in attending?
29. Which branch of service are you interested in joining?
30. Please list any medical issues that may prevent you from military service:
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