Cross Town ROTC Application
Purpose: Used by non-Marquette University students who have never attended Marquette and wish to enroll in Marquette ROTC courses, or those non-Marquette ROTC students who have previously attended
Marquette and stopped out for a semester, excluding summer. If dismissed in the last term of attendance, attach the Appeal Academic Dismissal/Satisfactory Academic Progress: Undergraduate form to this form.
Student Instructions:
1. Complete Sections 1 and 2 of this form using a computer.
a. a handwritten form will not be accepted.
b. an incomplete form will not be processed and returned for completion.
2. Print the form using the 'Print Form' button.
3. Sign the form in Section 3; a digital signature is not acceptable.
4. Submit the form to your ROTC Department.
Note:
a. Once your application has been processed, you will receive a letter from the University which will include your CheckMarq access credentials (user name and password).
b. Direct any questions to your ROTC Department.
ROTC Department Instructions:
Email the completed and signed form to otrdocs@marquette.edu.
Section 1: Student Information
Gender Male Female
Date of Birth
MM/DD/YYYY
Mobile Number
SSN
Relationship to YouPhone
Signature Date
Rev. 12/2015
Have you registered for Marquette courses in the past?
If yes, see Purpose under form title for additional requirements.
Yes No
Emergency Contact: Name
Permanent Address Phone Number
Home Institution Home Institution Student Email
Marquette ROTC
Program Enrolling
Air Force Army Navy Summer
Term / Year
to Enroll:
Fall Spring
Year
Marital Status
Section 2: ROTC Department Information
Section 3: Student Statement/Signature
I hereby request admission as a Cross Town ROTC student as indicated above and I understand that the ROTC Department into which I request admission has the final decision.
Section 4: ROTC Department Approval
Approved Regular
Approved Auditor
Denied
DateSignature
Comments (optional):
Title:
Rank:
Name:
White
Native Hawaiian
or Other Pacific Islander
Black or African American
Asian
American Indian or Alaska Native
What is your race?
(Check One or More)
No, I am not Hispanic or Latino
Yes, I am Hispanic or Latino
Are you Hispanic or Latino?
(Check One)
OtherU.S. Visa HolderU.S. Citizen, Permanent Resident or Immigrant
Citizenship (Check One)
Name
Last name, First name, Middle name
Permanent Address
street, city, state, zip code
Local Address
street, city, state, zip code
