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ROTC Enrollment Form

This document is an ROTC registration form for students at the Colegio de las Navas, detailing personal and contact information required for enrollment. It includes sections for academic history, emergency contacts, and parental information. The form also includes a certification section to confirm the student's registration in the ROTC program.

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raymartagustin013
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21 views1 page

ROTC Enrollment Form

This document is an ROTC registration form for students at the Colegio de las Navas, detailing personal and contact information required for enrollment. It includes sections for academic history, emergency contacts, and parental information. The form also includes a certification section to confirm the student's registration in the ROTC program.

Uploaded by

raymartagustin013
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
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ARMY 20240: WORLD-CLASS, MULTI-MISSION READY. CROSS DOMAIN CAPABLE.

HEADQUARTERS
DEPARTMENT OF MILITARY SCIENCE AND TACTICS
COLEGIO DE LAS NAVAS (AFFILIATED) ROTC UNIT
801st CDC, 8RCDG, ARESCOM, PA
Las Navas, Northern Samar

ROTC REGISTRATION FORM


(Print all Entries)

Student No:____________________ MS:______________________ Date:_______________


Name:______________________________________________________________________
(Last Name) (First Name) (Middle Name)
Temporary Address:
No/St/Vill/Brgy: ___________________________________________________________
Municipality: _____________________________________________________________
Province: ________________________________________________________________
Telephone/Cell Number: ____________________________________________________
Course: _________________ School: _____________________Religion: _________________
Date of Birth: __________________________ Place of Birth: ___________________________
Height: ________ Weight: ________ Complexion: _________ Blood Type: ________________
Permanent Address:
No/St/Vill/Brgy: ___________________________________________________________
Municipality: _____________________________________________________________
Province: ________________________________________________________________
Telephone/Cell Number: ____________________________________________________
Father:__________________________________ Occupation: ___________________________
Mother: _________________________________Occupation: ___________________________
Person to notify in case of emergency:
Name: ______________________________________ Relationship: ______________________
Address: _________________________________________ Tel No: ______________________
MS SEMESTER SCHOOL YEAR GRADE REMARKS
_____________ ______________ _______________ __________ ____________________
_____________ ______________ _______________ __________ ____________________
_____________ ______________ _______________ __________ ____________________
_____________ ______________ _______________ __________ ____________________
Are you willing to take the advance course? ( ) Yes ( ) No

______________________
(Signature of Student)
PAULINA S BENZON
LTC PA (RES)
Commandant
------------------------------------------------------------------------------------------------------------------------------
HEADQUARTERS
DEPARTMENT OF MILITARY SCIENCE AND TACTICS
801st CDC, 8RCDG, ARESCOM, PA
Las Navas, Northern Samar
__________________
(Date)
CERTIFICATION
TO WHOM IT MAY CONCERN:

THIS IS TO CERTIFY that _______________________College_________________


Is duly registered in the _________________ROTC program for the ____________Semester, School
Year _____________.

HONOR. PATRIOTISM. DUTY

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