TWO AND THREE YEAR SCHOLARSHIP
INSTRUCTIONS
(CADET COMMAND FORM 166-TEST-R)
 
  PRINT A COPY OF THE PRIVACY ACT STATEMENT AND HAVE THE APPLICANT READ AND
SIGN THE STATEMENT. RETAIN SIGNED COPY IN APPLICANT’S FILE.

Name: Names of Applicant (Last, First, MI)

SSN: Social Security Number of Applicant

Sex: M = Male F = Female

Race/Ethnic Group:

A = Asian or Pacific Islander
C = White, not Hispanic
H = Hispanic
B = Black, not Hispanic
T = American Indian or Alaskan Native
X = Other/Unknown
Resident Status: N = Non Resident
R = Resident
Type of Scholarship: Self-explanatory

Academic Major Code: Three letter code for the academic discipline being pursued. Code shown
must be the same as the discipline Listed on CC Form 104R

Block 1 - Age

Line 1a: Enter year of expected graduation, i.e., 2000 is 00, 2001 is 01

Line 1b: Enter applicants birth date, i.e., 26 April 1982 would be entered 820426

Line 1c: Subtract Line 1b from 1a. Remember these borrowing rules. If the day of birth exceeds 30
you borrow 30 days from the month column. if you need to borrow from the year column you will
move 12 months to the month column

Line 1d: Active military service from the DD 214. Subtract 1d from 1c and enter in 1e. If no active
military service is used transfer line 1c to 1e. If line 1e is less than 27 the individual’s age is okay
and you may circle YES in Line 1.

Block 2 - Citizenship: Self-explanatory

Block 3: - Dependents

Line 3a: Enter number of dependents including spouse and children but excluding the applicant.

Line 3b: Is the applicant married (yes or no)

Line 3c: If applicant is married is the spouse a member of the Armed Forces (except IRR)

Block 4 - Cumulative Grade Point Average: Self-explanatory. Grade Point Averages may not be
rounded up, i.e., 2.49 is a 2.4 GPA.

Block 5 - College Board Scores (SAT/ACT): 3-Year Scholarship Only

Line 5a: Enter SAT score Math and Verbal combined. If more than one SAT taken enter the total
of the Highest Mat and Verbal. For example: Test 1 520 Math 460 Verbal Total 980; Test 2 is 510
Math 500 Verbal Total 1010. Using split scores the total would be 520 Math (from test 1) and
500 Verbal (from test 2) total equals 1020.

Block 6 - ROTC Grade Point Average: Self-explanatory. Grade Point Averages may not be rounded
up, i.e., 2.69 is a 2.6 GPA.

Block 7 - Curriculum: Self-explanatory

Block 8 - Civil Convictions

Line 8a: Has applicant been arrested that resulted in charges being referred. If yes determine
disposition of the case.

Line 8b: Self-explanatory

Line 8c: Self-explanatory

Line 8d: Self-explanatory. Waiver required.

Line 8e: Self-explanatory. Waiver required.

Line 8f: Self-explanatory. Waiver required.

Block 9 - Prior Military Service

Line 9a: Self-explanatory

Line 9b and Line 9c: Check DD Form 214 for required data

Line 9d: Ensure applicant has less than 10 years of Active Federal Service

Block 10 - Military Junior College Only - High School GPA: Self-explanatory. Grade Point
Averages may not be rounded up, i.e., 2.69 is a 2.6 GPA.

If you want more information about Army ROTC, or you have any questions, please
contact  Major Jim Moreland at 1-800-777-ARMY(2769) or send Email by clicking
on the icon below:
 

Major Jim Moreland
 

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