Admissions Committee Review Form - Break-in-Service Cadet

Last Name: First Name: MI:

ID Number:

Anticipated Grade Level:

I understand my application has been referred to the NMMI Admissions Committee for review since I have been away from NMMI for more than regular break. I feel I would be a good candidate for re-admission because: (Please tell us why we should consider you for re-admission.)

What were the circumstances relating to your departure from NMMI originally?

What do you expect to gain from NMMI if re-admitted?

What have you done recently to improve your changes for successful re-admission to NMMI?

Will you be enrolling in the ROTC Early Commissioning Program (ECP) at NMMI (College Only)

Will you be an athlete at NMMI? - what sport(s):
Have you contacted the coach? If so, list name:
Have you signed a Letter of Intent to play (College Only) Yes No
Have you been invited to walk-on to the team? Yes No

What other NMMI opportunities are you considering?

Please type your name here as an electronic signature: Date: date

Current Phone Number: