Asr Form PDF Details

The Naval Reserve Officers' Training Corps (NROTC) Four-Year Alternative Scholarship Reservation (ASR) Form is an essential document for prospective scholarship applicants. Governed by several authoritative bodies, including sections of the United States Code and Executive Orders, this form serves a crucial role in determining eligibility for financial assistance through the NROTC program. The principal purpose of collecting this information is to evaluate candidates fairly and accurately for the ASR Four-Year Scholarship Contract. Designed with privacy in mind, it safeguards applicants' information under the Privacy Act, ensuring restricted usage and disclosure of the details provided unless specific exceptions apply. Applicants are required to furnish comprehensive personal and academic information, including biographical details, academic achievements, test scores, and extracurricular involvements. Furthermore, it inquires about physical fitness, leadership qualities, and a commitment to serve, which are integral to assessing a candidate's suitability for military service and the scholarship. Completing the form fully and truthfully is mandatory; failure to do so may impact the evaluation process. Additionally, both applicants and their guardians (if applicable) must attest to the truthfulness of the information provided, alongside completing other procedural requirements outlined for scholarship reservation. This rigorous application process thus ensures that only the most qualified and committed individuals are considered for the NROTC Four-Year Scholarship, illustrating the program's commitment to excellence and integrity.

QuestionAnswer
Form NameAsr Form
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other namesnstc 1533 106, officers training form pdf, naval reserve corps four, naval four alternative reservation

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NAVAL RESERVE OFFICERS' TRAINING CORPS FOUR-YEAR

ALTERNATIVE SCHOLARSHIP RESERVATION FORM

Privacy Act Statement

Authority: The authority to request this information is contained in: 5 USC § 301 (Authorizing Forms and Regulations); 10 USC § 2107 (Financial Assistance Program); Executive Order 9397 (Use of Social Security Numbers); and Executive Order 12549 (Debarment and Suspension).

Principal Purpose: The information is used to determine your eligibility for selection for the NROTC Alternative Scholarship Reservation (ASR) Four- Year Scholarship Contract. The information requested constitutes the minimum required to determine your current eligibility.

Routine Use: Information you provide in this application is protected by the Privacy Act and will not be released outside the Department of Defense without your permission unless it comes within an exception to the Act or one of the routine uses in 32 CFR § 701.112, http://www.privacy.navy.mil and the routine uses set forth here. If you are selected for an NROTC Scholarship, the information will be released to schools to which you apply. Your information and notification of status may also be provided to your high school so they may assist with the final stages of the process.

Disclosure: The information is voluntary; however, failure to answer any of the questions completely or to provide the information requested in this form, may result in an inability to fairly evaluate your qualifications for a NROTC ASR Four-Year Scholarship.

Name (Last, First, MI)

 

Social Security Number

Date of Birth

 

 

 

 

 

 

Address

 

Telephone

 

 

Male

 

 

 

 

 

 

Female

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Height (inches) ______________

Racial Category (Select One)

 

Weight (pounds) ______________

 

 

 

 

 

 

American Indian/Native Alaskan

 

Ethnic Category (Select one)

 

 

 

Asian

 

Hispanic/Latino

 

 

 

Black/African American

 

Non-Hispanic/Latino

 

 

 

Caucasian

 

Other: ___________________________________________

Native Hawaiian/Other Pacific Islander

 

Declined to Respond

 

 

 

Multiple: _________________________________________

 

 

 

 

 

Declined to Respond

 

 

 

 

 

 

 

 

 

 

 

 

Grade Point Average (4.0 Scale): ____________

 

Class Rank: ____________ of ____________

Percentile: _________ %

 

 

 

 

 

 

 

Test Scores: List one or both sets of test scores (If applicable)

 

 

 

 

 

 

 

 

 

 

 

ACT Test Date:

 

SAT Test Date:

 

 

 

 

 

 

 

 

 

English:

 

CR or ERW:

 

 

 

Math:

Math:

Extracurricular Activities: Please list all extracurricular activities and the number of years of participation

Leadership: Please list and explain all leadership positions, for example, Class Officer, Club Leadership, Athletic Leadership, etc.

Athletics:

 

Letter/Awards Received

 

Freshman _____________________________________________

Sophomore _____________________________________________

Junior ________________________________________________

Senior _________________________________________________

Community League Teams: _______________________________________________________________________________________

Individual Physical Fitness/Athletic Achievements: _____________________________________________________________________

Other: ________________________________________________________________________________________________________

NSTC 1533/106 (Rev. 6-16)

PREVIOUS EDITIONS ARE OBSOLETE

Page 1 of 2

NAVAL RESERVE OFFICERS' TRAINING CORPS FOUR-YEAR

ALTERNATIVE SCHOLARSHIP RESERVATION FORM (continued)

Applicant initials in the “TRUE” or “FALSE” column. A “FALSE” is disqualifying.

 

 

TRUE

FALSE

 

 

1.

I am a United States citizen.

 

 

2.

I will graduate from high school prior to NROTC unit enrollment.

 

 

3.

I have never been convicted of a DWI/DUI or felony.

 

 

4.

I have never taken any narcotic, sedative or tranquilizer drugs other than

 

 

 

prescribed by a physician or dentist; nor have I ever sniffed glue, used

 

 

 

marijuana, LSD, other hallucinogens, hypnotics, stimulants or other known

 

 

 

habit-forming drugs and/or chemicals; nor have I been convicted or arrested on

 

 

 

drug-related charges.

 

 

5.

I have no moral obligations or personal convictions, religious or otherwise, that

 

 

 

would preclude service in the military.

 

 

I understand that the U.S. Navy agrees to reserve an NROTC Scholarship in my name but that the scholoarship will only be awarded if I meet the following requirements:

I am at least 17 but will not be over 23 years of age prior to the beginning of the college academic year of intended

 

enrollment.

_____________

 

I provide official college board scores to the U. S. Navy NO LATER

 

THAN December 31st prior to high school graduation.

_____________

I complete the NROTC Four-Year Scholarship on-line application NO LATER

 

THAN January 31st prior to high school graduation.

_____________

I am found physically qualified by the DoD Medical Examination Review Board or granted a physical waiver.

_____________

 

I gain admittance to an NROTC school on my own initiative and am placed on that school’s unit by the Navy.

_____________

I have provided full, complete, true and accurate information on this form.

_____________

I further understand that regardless of my status with the school(s) of my choice, the Navy can only guarantee eventual unit placement (contingent upon my acceptance by the applicable school), but cannot guarantee placement in the unit of my choice.

I also understand that my completion of this form places me under no obligation to accept an NROTC scholarship.

___________

________________________________________

________________________________________

APPLICANT SIGNATURE

PARENT or GUARDIAN SIGNATURE

 

 

(Required if applicant is under the age of 18)

 

________________________________________

________________________________________

DATE

DATE

 

 

 

 

 

For NJROTC Area Manager Use Only

 

 

 

Area Manager’s Name: ____________________________________________________________

 

NJROTC Area Manager’s initials in the “TRUE” or “FALSE” column. A “FALSE” answer

 

 

TRUE

FALSE

is disqualifying.

 

1.Applicant meets eligibility requirements of paragraph 4 NSTCINST 1533.9C.

2.Applicant has taken ACT or SAT or has registered to do so.

3.Applicant appears to be physically fit, to be motivated for Naval service, and to have significant involvement in extracurricular activities or employment.

________________________________________

________________________________________

NJROTC AREA MANAGER SIGNATURE

 

DATE

 

 

 

 

NSTC 1533/106 (Rev. 6-16)

PREVIOUS EDITIONS ARE OBSOLETE

Page 2 of 2

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