The 104 R form is a Planned Academic Program Worksheet used by the Army Senior ROTC program. This form collects essential information to help manage and process students for commissioning in the Army. Completing this form accurately is crucial for determining eligibility and ensuring that all academic requirements are met.
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The 104 R form serves as a crucial tool for students enrolled in the Army Senior ROTC program, outlining their planned academic journey. This worksheet is designed to capture essential information such as the student's name, academic major, and grade point average, ensuring that all necessary data is collected for effective program administration. It allows for a comprehensive overview of the student’s academic progress, including credit hours completed, courses taken, and grades achieved. By detailing the remaining requirements for degree completion, the form helps determine eligibility for continued participation in the ROTC program. Furthermore, the 104 R form emphasizes the importance of voluntary disclosure, as it directly impacts a student's standing within the program. With a structured layout, the form guides students through the necessary steps to chart their academic path while adhering to public law and Army regulations. Timely completion of this form is essential, as it plays a significant role in the management of students’ academic plans and their eventual commissioning into the Army.
Completing the 104 R form is an important step in the academic planning process for students involved in the Army Senior ROTC program. This form provides essential information that helps determine eligibility for commissioning in the Army. Follow these steps carefully to ensure all required information is accurately filled out.
After completing the form, ensure all signatures are in place. This will help facilitate the processing of the student's academic plan and eligibility for the ROTC program.
Here are key takeaways regarding the completion and use of the 104 R form:
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The 104 R form, known as the Planned Academic Program Worksheet, is an essential document for students in the Army Senior ROTC program. It assists in tracking academic progress and ensuring that students meet the necessary requirements for commissioning. Along with this form, several other documents are commonly used to support the academic and administrative processes within the ROTC program. Below are a few key forms that often accompany the 104 R form.
These documents work together to create a comprehensive framework for managing a cadet's academic journey. Understanding each form's purpose can help students navigate their responsibilities effectively and ensure they meet the requirements for successful completion of the ROTC program.
PLANNED ACADEMIC PROGRAM WORKSHEET
For use of this form, see USACC Pam 145-4, the proponent agency is ATCC-PA-C
DATA REQUIRED BY PRIVACY ACT STATEMENT OF 1974
1.AUTHORITY: Title 10, US Code 2101 and 2104
2.PRINCIPAL PURPOSE(S): To provide information and data necessary for administering the Army Senior ROTC program, processing, and managing of selected students for commissioning in the Army IAW established public law and Army Regulations.
3.ROUTINE USE(S): To provide a projected academic plan to determine if the applicant meets the public law requirements of two remaining academic years.
4.VOLUNTARY DISCLOSURE AND EFFECT ON INDIVIDUAL NOT PROVIDING INFORMATION: Voluntary information is necessary to determine eligibility of the individual for acceptance,
continuance, or discontinuance in the Army ROTC program.
1. NAME OF STUDENT (LAST, FIRST, MI)
2. ACADEMIC MAJOR
2a. CIP CODE
3. AS OF DATE (MM/DD/YYYY) (Date of form preparation)
4. ACADEMIC SCHOOL
5. CREDIT HOURS
6. GRADE POINT AVERAGE (GPA)
Select Semester or Quarter (S/Q)
Semester
Term:
a. IDENTIFICATION (Check one):
Host
Curr GPA:
CUM:
CGPA:
Extension Center
a. Total required for degree:
1
Cross-Enrolled
(1) ROTC Hours that do not count:
(2) Total Hours Rqd for NAPS:
b. HOST SCHOOL
c. HOST FICE
Normal Academic Progression Standard
b. Credits toward degree Comp to date:
c. Transfer Credits accepted:
d. Remaining for Degree:
e. Number of authorized S/Qs:
7.TERM, YEAR, COURSE NUMBER, COURSE TITLE, COURSE CREDIT HOURS, CREDITS THAT COUNT TOWARDS ACADEMIC DEGREE, AND ACHIEVED GRADES.
a.
Year:
No.
Course Title
Hrs. Cts. Grd.
Total Term Hours:
d.
b.
e.
c.
f.
8. STUDENT INITIALS & DATE:
(Have the student initial and date beside each term to indicate they have been counseled)
TERM 1:
TERM 2:
TERM 3:
TERM 4:
TERM 7:
TERM 5:
TERM 8:
TERM 6:
TERM 9:
USACC Form 104-R, SEP 13
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7.TERM, YEAR, COURSE NUMBER, COURSE TITLE, COURSE CREDIT HOURS, CREDITS THAT COUNT TOWARDS ACADEMIC DEGREE, AND ACHIEVED GRADES. (CONTINUED)
g.
h.
i.
j.
k.
l.
m.
n.
o.
Hrs.
Cts.
Grd.
9. REVIEW: All of the above courses are required (as minimum) for the completion of the degree:
YES
NO (if no, list exceptions on reverside of this form).
Completion should result in
degree, during (Month, Year):
10.
SIGNATURE OF STUDENT:
11.
DATE: (MM/DD/YYYY)
12.
SIGNATURE OF REGISTRAR AND EXAMINER OF CREDENTIALS (OR OTHER INSTITUTION CERTIFYING OFFICIAL):
13.
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STATEMENT OF UNDERSTANDING
We, the undersigned, hereby declare that the program outlined on the worksheet (on the reverse side of this statement) that
Cadet
is about to under take a formally structured program approved by
(FULL NAME, Last, First, MI)
(Name of University or College)
designed to meet the requirments of a
degree; that the degree to be attained is the culmination of an
(Type of Degree)
undergraduate college program of at least four years; and that the remaining credit hours shown on the worksheet are necessary either to fulfill
discipline requirements or to fulfill credit hour requirements, or both, for the attainment of the degree. If the Cadet is an ROTC Scholarship
participant, the scholarship will be in force for the number of semesters indicated in Block 5.
(Date) (MM/DD/YYYY)
(CADET SIGNATURE)
(PROFESSOR OF MILITARY SCIENCE SIGNATURE)
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When filling out the 104 R form, it is essential to be meticulous and attentive to detail. Here’s a list of things to do and avoid: