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Contact information
NROTC Contact Information
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Email
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Your email
LName, FName
*
Your answer
Sex
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Female
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Navy or Marine
Navy
Marine
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College Program or Scholarship
College Program
Scholarship
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Ole Miss Email
*
Your answer
Ole Miss Student ID Number
*
Your answer
Personal Email
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What day is your move in schedule?
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DD
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YYYY
What time is your move in scheduled?
*
Time
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PM
Full Home Mailing Address
(Street Address, City, State Zip Code)
*
Your answer
Cell Phone number
*
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Emergency Contact (Name, Relationship to you & Phone Number)
Example: John Doe, Father, 123-456-7890
*
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Any Concerns or Questions?
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