THE ARMY RESERVE OFFICERS' TRAINING CORPS (ROTC) TWO-YEAR NON-SCHOLARSHIP PROGRAM FOR ACTIVE DUTY ARMY ENLISTED PERSONNEL

**IMPORTANT-PLEASE READ**

This application is for attendance at the University of Colorado at Colorado Springs (UCCS) or one of UCCS' partnership schools.  If you are interested in taking part in the Army ROTC Non-Scholarship Program at a different school you must contact that school for an application.  You may use this application as a reference applications to other institutions.

It is your responsibility to ensure that your application is complete and returned to:

University of Colorado at Colorado Springs, C/O Department of Military Science, ATTN: Recruiting Operations Officer, 1420 Austin Bluffs Parkway, Colorado Springs, CO 80918.

Deadlines: Your application must be complete and received no later than eight weeks prior to the start of the semester you begin your studies.  It is in your best interests to submit your application as early as possible.

If you change your address after you submit your application please notify the University of Colorado at Colorado Springs, C/O Department of Military Science, ATTN: Recruiting Operations Officer, 1420 Austin Bluffs Parkway, Colorado Springs, CO 80918 in writing or via E-Mail at rotcroo@uccs.edu .

Application Procedures
List of Green to Gold Program Points of Contact
Green to Gold Non-Scholarship Checklist
Instructions for Application
List of Approved Academic Disciplines
Green to Gold Non-Scholarship Application
Applicant Snapshot
DoDMERB  DD Form 2351
DoDMERB  DD Form 2492
Training Service Obligation Worksheet
Sample DA Form 4187 - Time-in-Service
Sample DA Form 4187 - Service Obligation
Statement of Understanding (Dependency)
Financial Statement

APPLICATION PROCEDURES

Read instructions carefully.  Print or type the information required.  Incomplete or inaccurate forms may eliminate you from consideration.  It is your responsibility to ensure that all required forms are submitted to University of Colorado at Colorado Springs, C/O Department of Military Science, ATTN: Recruiting Operations Officer, 1420 Austin Bluffs Parkway, Colorado Springs, CO 80918 and RECEIVED NOT LATER 60 DAYS PRIOR TO COMMENCEMENT OF EDUCATION. Incomplete docs will not be considered for the Non-Scholarship Program.  NOTE:  RETAIN A COPY OF ALL PAPERWORK FORWARDED FOR YOUR RECORDS.

Your completed application will consist of the following:  (NOTE:  See Checklist)

a.  Cadet Command Form 173-R (Application for U.S. Army ROTC Green to Gold 4-, 3-, and 2-Year Scholarship).  If your answer to Item 18, civil conviction is yes YOU MUST REQUEST A WAIVER OF THE DISQUALIFICATION.  The waiver request must be submitted with your application.  Include a complete written description of the offense, to include all circumstances leading up to arrest and conviction and complete sentence imposed, copy of the court record which indicated the charge, plea, and/or findings, as well as the sentence imposed and the record showing satisfaction of the sentence (when court records are not available this fact must be established by correspondence from the court), and three recent letters of character reference which indicate that the writer is aware of your specific situation requiring a waiver.  Your statement must be certified under oath.  If an offense occurs after you submit your application up to the date of discharge you must also inform this headquarters and request a waiver.

b.  Cadet Command Form 173-R (continued).  A favorable recommendation from your commanding officer and field grade commander commenting on your officer-like qualifications, i.e., leadership potential, appearance, personality, military record and aptitude for further military training.

c.  Cadet Command Form 103-R (Active Duty/Reserve ROTC Scholarship Applicant Snapshot).  Affix a recent (within the last 3 months) photograph, which will be retained by this headquarters.  A full-length photograph in uniform is requested.  Print your name and social security number on the back of the snapshot or photograph and on the form.

d.  A copy of APFT scorecard (DA Form 705) (must be within the last 6 months)

f.  Medical Examination. If you have had a medical examination and it is less than 24 months old  you may submit that DD Form 2807, or DD Form 2808 (MEPS/MTF) to DoDMERB requesting an upgrade via the remedial route to a DoDMERB equivalent exam. DoDMERB will probably identify several remedials such as a new eye exam and several history questions not present on a MEPS/MTF exam for completion by the applicant. A MEPS/MTF exam is not equivalent to a DoDMERB exam unless it has been upgraded first by DoDMERB via the remedial route. If no previous medical is available, please have your Commanding Officer/First Sergeant contact the Physical Exam section of TMC# 10, Fort Carson, CO and request they accomplish a physical IAW AR 40-29.  The following medical forms must be used.  When completing DD Form 2351, enter FICE: 004509 in block 8. If you are submitting a previous DD Form 2808, correct block 13 (Organization Unit and UIC Code) to read  FICE: 004509 .  If any additional tests or evaluations are required for final medical determination, DODMERB will return the packet to you at your unit of assignment.  DODMERB will return the completed physical back to this headquarters. You must be fully medically qualified for scholarship PRIOR to discharge.  Medical examinations must be submitted at the time of application to this headquarters.  This headquarters will forward the physical to DODMERB with the appropriate form for processing as an Army ROTC scholarship applicant.  DO NOT SEND THE PHYSICAL YOURSELF TO DODMERB.  Delay in forwarding physical could result in not being medically qualified in sufficient time to be released from the Army for enrollment.  The physical qualification process normally takes DODMERB anywhere from 6-8 weeks from start to finish.  Any remedials or follow-up required by DODMERB should be accomplished by you prior to announcement of acceptance.

g.  Official transcripts of all colleges you have attended.  The Professor of Military Science will not consider application docs with partial transcripts.  The school accepting you for attendance should establish a grade point average (GPA).  However, if GPA is not established by the school then the GPA from your latest complete transcript will be used.  If you have received college credit by means of the USAFI or CLEP tests, official results of such tests must also be furnished to this headquarters. College Grade Reports are not transcripts and are unacceptable.

h.  Letter of acceptance from a baccalaureate degree producing college or university offering Army ROTC indicating your status as an academic junior.  If you are undergoing academic studies and have not attained junior status at the time of application to a school, the letter may state that you are conditionally accepted pending final completion of current studies.  A follow-up letter and Cadet Command Form 104-R indicating your status will be required prior to you receiving your letter of acceptance.

i.  Letter from the Professor of Military Science (PMS) acknowledging contact has been made and they are aware of your pending enrollment in their program.

j.  Planned Academic Program Worksheet (ROTC Cadet Command Form 104-R.  The enclosed form indicating your academic status must be completed by the university's advising department or departmental head.  (Example:  If your intended major is Nursing, the 104-R must be from the School of Nursing.)  The Professor of Military Science will assist you in the completion of this form.  Verification form must indicate you have been accepted in the academic discipline that you indicate you will pursue.  Non-s cholarship recipients must attend the institution that provides the Form 104-R. Applicants who desire to attend a school other than the one which provided the initial 104-R must submit a subsequent 104-R verifying your academic status, letter of acceptance from the college/university prior to discharge. This form must be signed and authenticated by the student and the registrar.  Changing of schools between discharge and contracting will not be authorized.  Cadet Command Form 104-R containing summer sessions will not be accepted.

k.  Evaluation of Transfer of Credit.  If you will be attending a college/university other than the one from which you obtained your college credits, an evaluation of transfer of credits is required.  Evaluation should include course number and title, course grade, credit hours attempted and earned toward the degree pursuing and grade point average if available. (NOTE:  Some university systems may accept transfer credit for placement purposes and still require additional evaluation by the department awarding the degree. This may change your academic status)

l. Memorandum For Record describing your Student Athlete Leader (SAL) attributes as outlined in the Eligibility section.

m. Copy of waiver request (dependency, civil convictions, etc) if applicable.

n. CC Form 132-R.  Statement of Understanding (Dependency)

o. CC Form 228-R.  Financial Statement

Should you have questions or desire assistance in completing your scholarship application, you may contact the University of Colorado at Colorado Springs Army ROTC at: rotcroo@uccs.edu or 719.255.3475 or a unit located near your installation.  These units are listed in the  Green to Gold Points of Contact.  If you are stationed at a site outside the Continental United States, your local education center may provide assistance in completing your scholarship application.  If you have questions that cannot be answered through your education center, you may call a  Green to Gold Points of Contact.

NOTE:  Should you have any change in status (address, dependency, marital status, civil conviction, pregnancy, etc.) from the time you apply for a scholarship until notification of awards and discharge, you must inform this headquarters.

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List of Green to Gold Points of Contact

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INSTRUCTIONS FOR COMPLETING ROTC CADET COMMAND FORM 173-R U.S. ARMY ROTC GREEN TO GOLD 2-YEARNON-SCHOLARSHIP APPLICATION

To be completed by applicant

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