Girls State Personal Data Required Information Name* First Last Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone*Email* Enter Email Confirm Email Next of kin* Mr.Mrs.MissMs.Dr.Prof.Rev. Prefix First Last Relationship* Next of Kin information* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone*Email* Scholar informationHigh School Name* High School Graduation Year* High School GPA (Weighted) after JR year* ACT/SAT Composite*Have you/Are a member of a National Honor Society completed Honors/Advanced Placement course GPA over 3.0 and SAT/ACT over 1100/24 Please list all Honors and/or AP classes by year. For example- Honors Biology- FreshmanAthleticsPlease list all sports you participated in by year. For example Basketball- Freshman, Sophomore and JuniorList all varsity letters by sport and year. For example- Basketball- Junior yearList all leadership positions for athletic teams- For example- Basketball team captain junior year.List any active involvement in organized competitive (club, church league) team, sports or active involvement in individual athletic competitions (triathlon, mountain biking, running, etc.)LeaderList any elected leadership positions in student government, class, or activity by year. For example- Class president-sophomoreCaptain of academic team, scout leader, or positions held in JROTC/CAP/Sea Cadets/Young Marines or other similar organization by year. For example- JROTC 1SG- junior year.Positions of responsibility in organizations or clubs not already listed.MedicalHeight (inches) Weight (pounds) School of Choice- May list up to 5 colleges or universities in TN that offer Army ROTC.Physical Fitness AssessmentInstructions on how to conduct the physical fitness assessment and a link to download the scorecard can be found using the link at the bottom of the pageNumber of repetitions of push ups* Number of repetitions of sit ups* 1 mile run time MM:SS* School of attendance acknowledgment*I understand to be eligible to receive the Army ROTC Girls State Scholarship I must apply to, enroll in, and attend a 4-year college or university in the state of Tennessee beginning Fall 2019. If I fail to enroll in and participate in Army ROTC as required above the scholarship offer will be withdrawn and no scholarship benefits will be awarded.I do not agreeI agreeArmy ROTC Requirements acknowledgement*I understand that any scholarship offer is conditional based on being fully contract eligible in accordance with applicable Army and USACC regulations, pamphlets and guidance and that if I fail to meet any contracting requirements the scholarship is withdrawn and no benefits will be offered or awarded.I do not agreeI agree Physical Fitness Assessment Instructions. Physical Fitness Assessment Scorecard.