I certify that all information provided within this document is true and correct to the best of my knowledge. I submit this application subject to the penalties of the Pennsylvania Criminal Code, Title 18, Section 4904, relating to unsworn falsification to authorities. I understand that if I have withheld or given false information, I may be denied admission or dismissed from the Army ROTC program at Valley Forge Military College.
I Certify
DATA REQUIRED BY THE PRIVACY ACT OF 1974:
1. Authority: Title 10 USC 3012 (Section 2101 and 2111)
2. Principle Purpose: To obtain information to determine eligibility for participation in the Army ROTC Program; to provide information necessary for processing Basic Camp and advanced ROTC applications.
3. Routine Uses: To provide information on address and telephone numbers to facilitate contact with the candidate and his/her family; to make it a matter of record the physical characteristics of the candidate; to provide information essential for a fair evaluation of the candidate's acceptability for Basic Camp attendance or advanced ROTC participation.
4. Mandatory or Voluntary Disclosure and Effect on Individual: Disclosure of Social Security Number is mandatory and required for identification. Failure to provide your Social Security Number will preclude processing of the candidate's application. Disclosure of all other information is voluntary; however, failure to provide all of the voluntary information may delay or prevent the processing of applications for Basic Camp or entry into the ROTC advanced course.