Instructions for Filling out Forms
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*CDT CMD Form 139-R: http://www.msmary.edu/academics/militaryscience/enrollment_forms/139-R_Feb_2013.xls
Fill out PAGES 1 & 2 ONLY. Make sure you put blood type and height and weight. Host
school is McDaniel College FICE 002109. School of attendance is Mount St. Mary’s
University FICE 002086
Security Clearance Questionnaire (e-QIP):
http://www.msmary.edu/academics/military-science/enrollment_forms/SF86.pdf
This is a road map of information you will need when you complete your National
Security Clearance questionnaire. Within two weeks after contracting, answer all
questions and leave no blank areas. Within 60 days of contracting, you will be notified
by email that you have a security clearance case # through the Office of Personal
Management (OPM). This will require your input through a web-based application. At
that time you can use this as a road map to assist you in answering the applicable
questions to complete your security clearance input to OPM.
*DD Form 93: http://www.msmary.edu/academics/militaryscience/contracting_forms/DD_Form_93.pdf
In Block 13, you need to put your next of kin home phone number.
Fill out all blocks and sign. Use the following in block 3b: FICE 002109
DD Form 2005: http://www.msmary.edu/academics/militaryscience/contracting_forms/DD_Form_2005.pdf
Print, read and sign at bottom.
*DD Form 2058: http://www.msmary.edu/academics/militaryscience/contracting_forms/DD_Form_2005.pdf
Fill out, print, read and sign at bottom.
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*Asterisk denotes form is fillable in electronic format on your computer.
*Standard Form 1199A (Direct Deposit):
http://www.msmary.edu/academics/military-science/contracting_forms/Direct-DepositForm-SF-1199A.pdf
Fill out SECTIONS 1 & 3 ONLY of one page only (preferably the one labeled
government copy at the bottom). All cadet pay is disbursed through direct deposit into
your savings or checking account so make sure this information is ACCURATE.
*SGLV-8286 (Service Group Insurance):
http://www.msmary.edu/academics/militaryscience/contracting_forms/SGLV_8286_ed2013-04.pdf
Fill out and sign on bottom. Remember that the breakdown of percent must equal 100
per cent when you total the break down. Be advised that this is elective life insurance,
which you may or may not want or need.
*Form W-4:
http://www.irs.gov/pub/irs-pdf/fw4.pdf
Fill out and sign.
*CC Form 104-R (Two versions for MSM students):
 Version One is for NON-SCIENCE type majors—i. e. Poly Sci.
Criminal Justice, Econ. etc.
 Version Two is for SCIENCE/BIOLOGY type majors--i. e. hard
science & STEM type majors:
 I prepared a short video to help with completion of this form which I
can share with you if you provide a thumb drive
104 FOR NON-SCIENCE MAJORS
104 FOR SCIENCE/STEM MAJORS
104-R continued; it’s IMPORTANT for you to have an electronic copy of this available
on your laptop so you can easily notify battalion leaders of changes in major and/or
revisions in course load. Additionally, you will be updating this every semester to reflect
your academic status. Essentially, it is a road map to completing all of academic
requirements prerequisite to commissioning. This form can be filled out after you arrive
at school. However, it MUST be completed prior to you contracting. You will need to
have your school’s undergraduate catalog at hand when filling this out so you can plug
in the “core curriculum” requirements as well as those associated with your academic
major.
Finally, Block specific guidance for block. 4 entries: McDaniel College is the Host
Institution, Hood and Mount St. Mary’s University are considered “Cross-enrolled”
institutions. Thus, if you are attending McDaniel, block 4c does not need to be filled out.
CC Form 136-R:
http://www.msmary.edu/academics/military-science/contracting_forms/CC-Form-136R_AUG_01.doc
Read and sign
*CC Form 137-R:
http://www.msmary.edu/academics/military-science/contracting_forms/CC-Form-137R_AUG_02.xls
Read and sign
*DD Form 2266 (Hometown News Release):
http://www.msmary.edu/academics/militaryscience/contracting_forms/DD_Form_2266_JUN_95.pdf
Fill out and sign. This enables the ROTC department to release good news about you to
your hometown newspapers. If you do not want items released, check “do not release”.
*DD FORM 3425-R:
http://www.msmary.edu/academics/military-science/enrollment_forms/DA_Form_3425R_Medical%20Fitness%20for%20Enrollment.xls
GOOD WORDS: this WILL NOT apply to most of you because likely you have already
been medically cleared by the Department of Defense Medical Examination Review
Board (DoDMERB). However for those of you are not yet medically cleared by
DoDMERB, you will need to this form on file. If you fall into the latter category, you will
need to have this signed by your family doctor in order to participate in the ROTC
physical training program. Call if you are unsure whether you need this or not.
Statement from Dentist –ROTC Form 2657:
http://www.msmary.edu/academics/military-science/contracting_forms/DentalForm_2657_JAN_06.pdf
This form must be filled out prior to you reporting for first day of school, you will not be
allowed to participate with ROTC until this form is complete. GOOD WORDS: This does
not require your dentist’s signature; just fill in his/her name, office address, and phone #,
and mark the records that are on file (e. g. bite wings etc.)