Vfmc Army Rotc Program Application Form Page 4
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8Extracurricular/Athletic/
Name (Last, First, Middle)
_________________________
Leadership Activities Record
SSN: ____________________
Valley Forge Military College Army ROTC Scholarship Application
A. Instructions Indicate below your participation in extracurricular, athletic and leadership activities.
Any recognized activity not listed should be in “other.” Be certain to indicate all leadership
positions held. If additional space is needed, use the space provided in section E.
In section D list all after school work.
Date and sign the form in block F.
B. Athletic Activities
Check Box if none.
Grade
Grade
Grade
Grade
Sports
Baseball / softball
Basketball
Boxing
Football
Golf
Gymnastics
Hockey
Soccer
Swimming
Track
Tennis
Wrestling
Rifle team
Other (explain)
C. Extracurricular Activities
Check box if none.
Type
# of years
Success Achieved
(Awards, positions of leadership, etc.)
Church Group
Debate
Dramatics
Scholastic Societies
School Band
School Newspaper
Student Government
Yearbook
Drill Team
Agriculture
Social Fraternities
Junior ROTC
Other (explain)
Modified ROTC Cadet Command Form 105-R, OCT 91
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