DA FORM 3126, SEPTEMBER 2010 PREVIOUS EDITIONS ARE OBSOLETE
APPLICATION AND CONTRACT
FOR ESTABLISHMENT OF A JUNIOR RESERVE OFFICERS’ TRAINING CORPS
For use of this form, see AR 145-2; the proponent agency is DCSPER
Form Approved
OMB Number 3126
Expires 09/01/2012
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APPLICATION
By direction of the governing official of
(Name of School System / District)
, an application is hereby submitted for
(City, State, Zip Code)
the establishment of a unit of the Junior Army Reserve Officers’ Training Corps under the provisions of section 2031, Title 10, United States Code at
(Complete Name and Address of School)
CONTRACT
1. Contingent upon the acceptance of the above application and conditioned upon the
fulfillment of all promises enumerated in paragraph 2 following, the Secretary of the Army
agrees as follows:
a. To establish a Junior unit of the Army Reserve Officers’ Training Corps (JROTC) at
the school named above.
b. To assign such military personnel as the Army may deem necessary for the proper
administration and conduct of the Junior ROTC unit at this school and to pay the statutory
compensation to such personnel from Department of the Army appropriations.
c. To provide for use in the Junior ROTC unit such available government property as
may be authorized by law and applicable tables of allowances;
2. Contingent upon the acceptance of this application by the Secretary of the Army, and
conditioned upon the fulfillment of the promises enumerated in paragraph 1 above, the
governing authorities of this school agree as follows:
a. To provide appropriate academic credit applicable toward graduation for a course of
instruction as prescribed by the Secretary of the Army, which will be ______ required, or
______ elective.
b. To conduct the following type of JROTC training:
______ (1) Academic track; ______ (2) Technical track; and ______ (3) To establish
the unit as a ______ single unit, or ______ a part of a multiple unit system; and to
establish the unit as a 3year ______ , or 4 year ______ program; and to establish the
unit as a Class High School (HS) ______ or a Military Institute (MI) ______ .
c. To make available for use by the Junior ROTC unit necessary and adequate
classrooms, administrative offices, office equipment, storage space, drill area, and other
required facilities, and to pay the costs of utilities and maintenance thereof. To make
available in the Junior ROTC administrative office a telecommunications line suitable for
voice transfer, Internet connectivity, and data transfer and to pay the costs of installation and
maintenance thereof to include phone calls (local and official
long distance).
d. To employ certified instructors authorized and approved by the Army to administer the
Army approved courses, (a minimum of one officer and one noncommissioned officer per
unit). Contract periods will be negotiated to permit year round management of the program
and control of government property. Instructor contracts may be extended up to 21 days to
allow instructors to attend JCLC camp. These extensions will be approved on a case-by-
case basis. School authorities agree to pay retired Army JROTC instructors in accordance
with applicable federal law and regulations. Schools are encouraged to reimburse the Junior
ROTC instructors on a comparable scale as other teachers employed at the school. Schools
will ensure that instructors are provided liability insurance to the same extent and
in a like manner as such insurance is provided to other teachers and coaches through the
school for school sponsored activities or duties (including extra-curricular activities, i.e.,
annual encampments, adventure training, drill competitions, marksmanship competitions,
etc). Schools will provide Junior ROTC Cadets insurance to the same extent and in like
manner as provided other students (including extra-curricular activities).
e. To request from CG, U.S. Army Cadet Command permission to hire, by name and
position, the individuals to be employed as the Senior Army Instructor and Army Instructor.
f. To appoint a military property specialist (MPS) who is not on active duty with the Army
and who will be empowered to requisition, stock, and account for government property
issued to the school and otherwise to transact matters pertaining thereto, for and in behalf of
the school. If this duty is assigned to a retired Army individual who is also employed as a
Junior ROTC instructor, that person will be provided a minimum of one class period daily, in
addition to their planning period, to complete MPS requirements.
g. To notify the CG, U.S. Army Cadet Command of the name and position of the
individual designated as military property specialist.
h. To conform to the current laws and regulations relating to issue, care, use,
safekeeping, turn-in, and accounting for such government property as may be issued to the
school.
i. To comply with provisions of law, and the regulations of the Secretary of the Army,
pertaining to the furnishing of a bond and/or insurance to cover the value of all government
property issued to the school, except expended articles, and supplies properly expended in
operations, maintenance, and instruction.
j. To maintain an enrollment in the institution of not less than 100 physically fit students
(or 10% of the eligible student population, whichever is less) who are in a grade above the
8th grade.
k. To adhere to a policy of nondiscrimination on the basis of race, religion, color, gender,
sex, marital status, political affiliation, physical ability, nation origin, sexual orientation or
status as apparent, with respect to admission or subsequent treatment of students and
instructors.
l. To require instructors to wear Army uniforms to accomplish Junior ROTC duties and
maintain Army standards of physical fitness, appearance, and height and weight. Any
additional duties given to instructors while in uniform will be appropriate and in no way
demean the individual, the uniform, or the U.S. Army.
m. To encourage and support the professional development of Junior ROTC instructors
and permit attendance at U.S. Army sponsored orientation, refresher training, workshops,
and conferences.
n. To assist the Army in determining the quality of instruction by evaluating the
performance of instructors.
o. To conform to the regulations of the Secretary of the Army relating to the conduct of
the Junior ROTC.
Page 2, DA Form 3126, September 2010
3. It is mutually understood and agreed as follows:
a. That this contract shall become effective when the authorities of this school have been
notified officially that the Army has approved the establishment of a Junior ROTC unit on the
date specified.
b. That the Army shall have the right at any time to withdraw approval and authorization of
any personnel employed by the school pursuant to paragraph 2d above. Such withdrawal of
authorization of any personnel employed by the school pursuant to paragraph 2d above will
require the decertification of the individual from the Junior ROTC program.
c. That this contract may be terminated in the following manner:
(1) At any time, by mutual consent and agreement of both parties.
(2) Upon the giving of one year’s notice of such intent to terminate by either party.
(3) If the Junior ROTC unit is placed on probation pursuant to regulations prescribed
by the Army.
(a) This contract will terminate at the end of one year from the date the unit was
placed on probation, unless the reason for such probationary status has been removed to the
satisfaction of the Army prior to such expiration.
(b) For enrollment, if the JROTC unit is in at least its third year of operation and does
not satisfy the enrollment requirements in 2j above, the unit will be immediately placed on
probation. If enrollment requirements are not met within 30 days of the beginning of the next
school year, the contract will be terminated at the end of that school year.
4. This contract supersedes all existing contracts between the Department of the Army and
the school pertaining to this matter.
FOR THE SCHOOL
TYPED NAME AND TITLE
SIGNATURE DATE
FOR THE SECRETARY OF THE ARMY
TYPED NAME AND TITLE
SIGNATURE DATE
THE FOLLOWING AGREEMENT AND INFORMATION IS TO BE CONSIDERED AS PART OF THIS CONTRACT
AGREEMENT REGARDING FACILITIES TO BE PROVIDED FOR THE USE OF THE
ARMY RESERVE OFFICERS’ TRAINING CORPS PROGRAM, WITHOUT EXPENSE TO THE DEPARTMENT OF THE ARMY
The authorities of the above-named institution agree that the facilities specified below shall be furnished for the use of the Army JROTC program, without expense to the
Department of the Army (phrases such as “as needed”, “as required”, etc., will not be used in describing the following):
1. OFFICES
2. STORAGE ROOMS
ROOMS
SIZE
BUILDING IN WHICH LOCATED
EXCLUSIVE OR JOINT USE
NO. OF
ROOMS
EXCLUSIVE OR JOINT USE
NOTE: Storage rooms, particularly for clothing and small articles of equipment, must be adequately lighted and ventilated and provided
with shelving, cabinets, and locked arms racks. Windows must be securely barred and doors reinforced and fitted with cylinder locks.
3. CLASSROOMS
NO. OF ROOMS AND BUILDING SEATING CAPACITY EXCLUSIVE OR JOINT USE
NOTE: Classrooms must be adequately lighted and ventilated and provided with standard equipment. If joint use is specified, rooms
must be available for Army JROTC classes when scheduled.
Page 3, DA Form 3126, September 2010
4. ASSEMBLY HALL
a. SEATING CAPACITY b. PROJECTION EQUIPMENT IF PROVIDED FOR c. WILL BE AVAILABLE FOR ARMY JROTC CLASSES AS
FOLLOWS:
5. GYMNASIUM
a. SIZE OF GYM OR OTHER
INDOOR DRILL AREA
b. WILL BE AVAILABLE FOR ARMY JROTC CLASSES AS FOLLOWS:
6. OUTDOOR DRILL AREA
a. SIZE b. WILL BE AVAILABLE FOR ARMY JROTC CLASSES AS FOLLOWS:
7. TARGET RANGE INDOOR OUTDOOR
a. NO. OF FIRING POINTS b. WILL BE UNDER JURISDICTION OF
8. REMARKS
Institutions should retain a copy of the contract and send the original to the designated JROTC Brigade:
COMMANDER
2
ND
BDE, USACC
ATTN: ATCC-BBJ
(JROTC)
5212 Maryland Ave
Fort Dix, NJ 08640
Connecticut
Maine
Massachusetts
New Hampshire
New Jersey
New York
Pennsylvania
Rhode Island
Vermont
Germany
Italy
COMMANDER
3
RD
BDE, USACC
ATTN: ATCC-CCJ
(JROTC)
2730 Sampson
Street, Bldg 73,
Naval Station,
Great Lakes, IL
60088
Iowa
Illinois
Kansas
Michigan (UP)
Minnesota
Missouri
Nebraska
North Dakota
South Dakota
Wisconsin
COMMANDER
4
th
BDE, USACC
ATTN: ATCC-DDJ
(JROTC)
2175 Reilly Road
Stop A
Fort Bragg, NC
28310
District of Columbia
Delaware
Maryland
North Carolina
South Carolina
Virginia
West Virginia
COMMANDER
5
th
BDE, USACC
ATTN: ATCC-EJR
(JROTC)
1265 Buck Road
2
nd
Floor
Fort Sam Houston,
TX 78234
Arkansas
Arizona
Colorado
North Mexico
Oklahoma
Texas
Utah
Wyoming
COMMANDER
6
th
BDE, USACC
ATTN: ATCC-FFJ
(JROTC)
246 Blanton Road
Building 1031
Hunter Army
Airfield, GA 31409
Alabama
Florida
Georgia
Louisiana
Mississippi
Puerto Rico
Virgin Islands
COMMANDER
7
TH
BDE, USACC
ATTN: ATCC-GGJ
(JROTC)
1468, 328
3
RD
Avenue
Fort Knox, KY
40121
Indiana
Kentucky
Michigan
Ohio
Tennessee
COMMANDER
8
TH
BDE, USACC
ATTN: ATCC-HHJ
(JROTC)
Box 339500
Mail Stop MS 83
Joint Base Lewis-
McCord, WA
98433
Alaska
American Samoa
California
Guam
Hawaii
Idaho
Mariana Islands
Montana
Nevada
Oregon
Washington
Japan
Korea
Page 4, DA Form 3126, September 2010
9. DATA PERTAINING TO SCHOOL
a. NAME OF SCHOOL (No abbreviations) :
b. SCHOOL’S COMPLETE MAILING ADDRESS (Include ZIP code):
(If P.O. Box must also provide street address for shipping purposes)
c. TYPE OF SCHOOL(Check appropriate box):
______ Municipal ______ State ______ Denomination (Specify)
d. PRINCIPAL’S NAME:
e. TELEPHONE NUMBER:
f. FAX NUMBER:
g. E-MAIL ADDRESS:
10. PERTAINING TO DISTRICT
a. NAME OF DISTRICT (No abbreviations) :
b. DISTRICT’S COMPLETE MAILING ADDRESS (Include ZIP code):
c SUPERINTENDENT’S NAME:
d. TELEPHONE NUMBER:
e. FAX NUMBER:
f. E-MAIL ADDRESS:
11. LIST ACCREDITING AGENCY
a. REGIONAL
b. STATE
C. OTHER
12. TOTAL ENROLLMENT OF SCHOOL
13. ESTIMATED NO. OF QUALIFIED STUDENTS WHO WILL ENROLL IN
THE JROTC PROGRAM
14. LIST TECHNICAL COURSES OFFERED AT SCHOOL:
15. WILL STUDENTS BE GIVEN A MEDICAL EXAMINATION:
16. BAND:
a. THE BAND ______ WILL // ______ WILL NOT BE AVAILABLE FOR JUNIOR ROTC CEREMONIES?
b. THE BAND WILL BE A ______ SCHOOL BAND // ______ JUNIOR ROTC BAND.