ROTC Crosstown Admission Form

This form is intended for students who have NOT been admitted into the IIT ROTC Crosstown program and are seeking academic credit from Illinois Institute of Technology as part of their ROTC registration. If you previously submitted this form and need any assistance, please contact the IIT Office of the Registrar at registrar@iit.edu.

All course fees and tuition charges apply and are the responsibility of the student, unless otherwise specified per the terms of a crosstown agreement between the student’s primary institution and Illinois Institute of Technology. For billing details, contact the IIT Student Accounting Office at sa@iit.edu.

Your Name * First Middle Last
Date of Birth * / MM / DD YYYY
IIT Start Term *
IIT Start Year *
Must be 4 digits. Currently Entered: 0 digits.
Gender *

Gender Male Female
Daytime Phone Number
(text capable preferred) * - ### - ### ####
Permanent Address *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Your School Email Address
(assigned by your home institution) *
Your Personal Email Address
(optional)
Are you currently eligible to use Veterans Benefits? *

Are you currently eligible to use Veterans Benefits? No Yes
Military Branch *

Military Branch Air Force Aerospace Studies - AFAS Military Science (Army) – MILS Naval Science (Navy) – NSCI
Primary Institution (your home college/university
where you are currently enrolled) *
Previous Institutions (previous colleges/universities
where you are no longer enrolled)
Emergency Contact's Name * First Last
Emergency Contact's Phone Number * - ### - ### ####
Emergency Contact's Relationship to You *

Emergency Contact's Relationship to You Parent/Guardian Spouse Sibling Other Other
ROTC Crosstown Admission Information

By submitting this form, you attest that all the information provided is true and accurate at the time of submission. You will receive an email confirmation at the school email address you provide.

Contact the IIT Office of the Registrar at registrar@iit.edu with questions or for assistance with registration.

ROTC Crosstown Admission Form

ROTC Crosstown Admission Form

ROTC Crosstown Admission Information