Army ROTC Cadet Enrollment Paperwork
Here you will find all the documents you need in order to participate in the Army ROTC program outside of the classroom setting. Please print out the first three links below to properly complete your enrollment packet. If you click on each form document title below, it will open the form so you can type right on the form. You will not be able to save the typed form, so print it before you close it out.
Please be sure to select the correct form associated with the school you will be attending, i.e. CU-BLD, CSM, MSU, CCU, DU or CU-DNV.
If you need any assistance in properly filling out the forms, you should contact eitherÌý
ROO at: 303-492-3549 or email her at kim.hageman@colorado.edu
HRA at: 303-492-3158 or email her at mechille.zook@colorado.edu.
Enrollment Checklist
Pre-Screening Questions
Enrollment Pack Instructions
Dental Memo
Waiver of Liability
CC Form 136-R – Government Benefits Brief
CC Form 137-R – Access to Student Records Authorization
DA Form 3425-R – Medical Fitness Statement
DD Form 2005 – Privacy Act Statement-Health Care Records
DD Form 2983 – Cadet Prohibited ActivitiesÌý
DD Form 2058 – State of Legal Residence
CC Form 139 – Cadet Application and Enrollment Record (CU-BLD)
CC Form 139 – Cadet Application and Enrollment Record (CSM)
CC Form 139 – Cadet Application and Enrollment Record (MSU)
CC Form 139 – Cadet Application and Enrollment Record (CCU)
CC Form 139 – Cadet Application and Enrollment Record (DU)
CC Form 139 – Cadet Application and Enrollment Record (CU-DNV)
CC Form 104R – Planned Academic Worksheet (CU-BLD)
CC Form 104R – Planned Academic Worksheet (CSM)
CC Form 104R – Planned Academic Worksheet (MSU)
CC Form 104R – Planned Academic Worksheet (CCU)
CC Form 104R – Planned Academic Worksheet (DU)
CC Form 104R – Planned Academic Worksheet (CU-DNV)
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