(Typed or Printed Full Name) (Social Security Number)

1. Having volunteered for guaranteed training in the__________________ Program and enlistment in the U.S. Navy, in rat/paygrade ____________, under the provision of the Navy College Assistance/ Student Headstart (Navy-CASH) Program, I hereby acknowledge that:

a. I am enlisting in the U.S. Navy for an active period of four years and agree to concurrently execute an Agreement to Extend Enlistment (NAVPERS 1070/621 for ________ months in order to meet the minimum service obligation for the __________________ Program, based on my Course of Study Plan (NAVCRUIT 1130/19) and RTC commencement date of ____________ (mm/yyyy). My paygrade while in Navy-CASH will be _______. My obligated service (enlistment plus extension), from the time I enter Recruit Training at RTC Great Lakes, will meet all service requirements for the program in which I am enlisting.

b. I will receive orders to active duty and will be assigned to Navy Recruiting District ____________ while attending college and awaiting orders to Recruit Training Command (RTC).

c. Upon enlistment, I will be subject to the Uniform Coed of Military Justice (UCMJ) and to all orders, instructions ad directives issued by competent authority, including those of the Commanding Officer of the activity to which I am assigned. For purposes of the USMJ, class attendance and other activities related to my course of instruction, shall be considered as military duties and are military service connected. As a member of the Nuclear Field Program, I understand that I am required to complete one (1) college level algebra course and one (1) physics-based science course with a letter grace of C or better prior to RTC.

d. In the event I fail to maintain qualifications and/or eligibility for training in my selected program for any reason other than physical, I will be ordered to RTC at the end of the school term in which I am enrolled as a General Detail (GENDET) in the Seaman Apprenticeship Program. I will be obligated to service the remainder of my four-year contract, but may have my Agreement to Extend Enlistment (NAVPERS 1070/621) canceled. Reclassification into another rating/program may be requested via CNRC (Code 382) and will be considered based upon my qualifications and the needs of the Navy. I understand that additional obligated service may be required for reclassification into another program.

e. If I remain qualified for my selected program and request voluntary disenrollement form Navy-CASH, I will be ordered to RTC and appropriate follow-on training. Orders to RTC will be issued within 30 days after the completion of the school term in which I am enrolled.

f. If I am found not physically qualified for my selected program, I may be reclassified for training in another available rating/program based upon my qualifications and the needs of the Navy. I understand that my new rating/program may require a different term of obligated service. It is further understood that I may elect to either accept training under this new rating/program or accept orders to RTC as an undesignated GENDET in the Seaman Apprenticeship Program for the remainder of my four-year enlistment.

g. If the Chief, Bureau of Medicine and Surgery, recommends me for separation due to medical reasons, I will normally be processed for separation on the date the recommendation is approved. When a delay in processing is involved, I understand that I will be retained in my current paygrade until such determination has been completed and I have been discharged or until execution of orders to RTC is imminent.

h. Drug usage in the Navy is prohibited and will not be tolerated! I understand that urinalysis testing will take place within 72 hours upon arrival at RTC. Additionally, I may be subject to random urinalysis testing while serving in the Navy-CASH Program. If I test positive, I will be discharged based upon fraudulent enlistment. Alcohol abuse or illegal or improper use of drugs during my enlistment could result in punitive action, administrative separation with less than honorable discharge, and loss of veteran benefits.

i. I have been briefed on and have selected an enlistment incentive. I have selected ________ (enter enlistment incentive, e.g. EB-$12,000).

j. Should I decide to reenlist under the Selective Training and Reenlistment Program (STAR), I understand that I may have up to 24 months (6 YO programs) or up to 12 months (5 YO programs) of my enlistment extension forgiven for the purpose of calculating my Selective Reenlistment Bonus.

a. I must maintain a term and cumulative grade point average (GPA) of at least 2.5 on a 4.0 scale.

b. I will not be allowed to increase my projected time in college, extend my Course of Study Plan, or RTC reporting date, enter into an exchange program, or transfer schools without the specific permission of CNRC (Code 382).

c. I will enroll as a full time student at my school during all regularly scheduled semesters or quarters, including summer sessions, and I am responsible for the payment of tuition, books and all related college debts.

d. I will have my school submit an official copy of my grades or transcripts to CNRC (Code 382), via the Commanding Officer of the Navy Recruiting District to which I am assigned, within 30 days of completion of each semester/quarter term, until completion of my Course of Study Plan. I understand that failure to provide transcripts as required may result in early transfer to RTC.

e. I will notify my NRD Commanding Officer immediately of any experimental drug involvement, change in dependency, medical condition, or any civil or criminal involvement.