Vfmc Army Rotc Program Application Form Page 3
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8ROTC Scholarship Applicant Snapshot
Data required by the Privacy Act of 1974
1. Authority: 10 USC 2101 and 2107 2. Principal Purpose(s) To physically identify each applicant 3. Routine Uses: To be used by
the ROTC selection board in consideration of the applicant. 4. Mandatory or voluntary disclosure and effect on the individual for
not providing the information: Use of this form is mandatory, applicant may not be considered if picture is not submitted.
Attach recent snapshot
(within last 3 months)
Full length preferred,
at least knees up
Signature of Applicant: ________________________________________
Name: __________________________________________ SSN: ________________
(Last, First Middle)
Current Height: ____________ Current Weight: ________________
Month and Year of Photo: ________________________
Modified ROTC Cadet Command Form 103-R, Feb 89
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