Vfmc Army Rotc Program Application Form
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8Valley Forge Military College
Army ROTC Application for
Early Commissioning Program
Instructions: Print this form using Adobe Acrobat reader to fill in all the information electronically.
Submit form along with your original birth certificate to the address below. Please feel free to
place a collect phone call to (610) 687-9495 if you have any questions. This application in no way
commits you to military service.
Submit this completed application form with your original birth certificate to:
Valley Forge Military College
Army ROTC
1001 Eagle Road
Wayne, PA 19087
Type or Print Clearly:
Name:______________________________________________________________
Local Address: ______________________________________________________________________
Home Phone: _____________________________ E-Mail Address: __________________________________
Date of Birth: _____________________________ Social Security Number: ____________________________
Place of Birth: ___________________________________________________ U.S. Citizen: Yes ____ No ____
Academic Info:
High School Attended: _________________________________________________________________
High School Address: __________________________________________________________________
High School Phone number: ____________________________ High School Graduation Date: ___________
High School guidance Counselor’s Name:_____________________________________________________
JROTC Participation: Yes ____ No ____ If Yes, for how long?
Senior Army Instructor’s Name: _______________________________________________________
Prior Service: Yes ____ No ____ If yes, please indicate the following:
Active _____ Reserves ______ National Guard ______
If discharged, enter Reenlistment Code here: ____________
Unit Name: ____________________________________________ Unit Phone: ________________________
Unit Address: ________________________________________________________________________
Please forward a copy of one of the following, as appropriate:
DD Form 4 (Guard and Reserve only)
DA Form 220
DD Form 214
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