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*Denotes required fields.
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*First Name:
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*Last
Name:
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*Address:
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*City:
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*State/Province:
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*Zip/Postal
Code:
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| *State
of Residency, where you or your parents pay
taxes: |
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*Phone
Number:
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Fax Number:
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*E-mail:
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Please
tell us about yourself
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Military
Information
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*How
did you learn about our program?
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Do you have prior military service?
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If yes, what branch of military service?
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What Army Officer Branch are you interested
in?
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*Academic Standing
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Are you interested in applying for an Army
scholarship?
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If yes, do you know what type of scholarship
interests you?:
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*What
university or college do you attend?
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How old are you?
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Privacy Act Notice:
The above disclosure is voluntary. All information
will be used strictly for Department purposes.
The authority for the collection of this information
is Title 10, United States Code, Sections 503,
505, 508, and 12102, and EO 9397. |
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