Cal State Fullerton Army ROTC Initial Interview Worksheet

(If you would like to setup an appointment to discuss your eligibility to join ROTC please complete and return this form via email to Mr. Steven Yach at )

Appointment Date: / Time: / Student ID :

Personal Information

Today’s Date / Student ID
Last Name / Mission Set
First & Middle Name / Gender
Mobile Phone / MS Class
Home Phone / City You Were Born In
Primary Email / State You Were Born In
Secondary Email / Country You Were Born In
Home Address / Are You a US Citizen?
City / State\Zip Code
Birthday(MM/DD/YYYY) / What’s Your Age?
SSN / Are You Married?
GPA / Do You Have Children?
SAT Score / ACT Score
Additional Information Requirements
What’s your height and weight?
What college are you attending?
What university are you planning to transfer to?
How many college units have you completed?
What’s your major?
Are you a full time student?
Do you have any prior military service?
How many years of active duty or reserve?
Do you have any military disciplinary actions?
Do you have an honorable discharge?
Do you have any law violations?
Do you have asthma?
Do you have any permanent injuries?
Do you want to serve on Active Duty, Reserve?
Do you want to serve in the National Guard?
How did you hear about ROTC?
Any issues or concerns at this time?

For more information call CSUF Recruiting Operations Officer Mr. Steven Yach - Office (657) 278-3527