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University of Illinois NROTC Contact Request Form
Please complete the following form to be put in contact with our midshipman recruiting officer
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* Indicates required question
Title
*
Mr.
Ms.
Other:
First name
*
Your answer
Last name
*
Your answer
Phone number (Ex: "111-111-1111")
*
Your answer
Email address (Ex: "
johnsmith@gmail.com
")
*
Your answer
Current academic year
*
High school freshman
High school sophomore
High school junior
High school senior
College freshman
College sophomore
College junior
College senior
Other:
Branch of service most interested in
*
Navy
Marine Corps
Required
Are you an Illinois Resident?
*
Yes
No
Please submit any questions or let us know here if you would like to schedule a Zoom meeting, phone call, or in-person visit.
Your answer
How did you hear about us?
*
Registration day outreach event
Quad day outreach event
Referral from a friend or family member
Social media (Facebook or Instagram)
UIUC Navy ROTC Website
Email communication
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