The 104 R form, known as the Planned Academic Program Worksheet, is essential for students in the Army Senior ROTC program. This form helps to outline the academic plan necessary for students to meet their degree requirements while ensuring compliance with public law and Army regulations. Completing the 104 R form is a crucial step for those seeking commissioning in the Army.
The 104 R form, also known as the Planned Academic Program Worksheet, is primarily designed to gather essential information for managing the Army Senior ROTC program. It helps in assessing whether students meet the academic requirements necessary for commissioning into the Army. The form collects data about the student’s academic major, credit hours, GPA, and course details to ensure compliance with public law and Army regulations.
This form is required for students enrolled in the Army ROTC program. Specifically, it is intended for cadets who are planning their academic programs and need to demonstrate that they can complete their degree requirements within the stipulated time frame. Cadets must provide accurate and comprehensive information about their academic progress and future coursework.
When completing the 104 R form, students must provide various details, including:
This information is crucial for evaluating the cadet’s academic standing and progress toward their degree.
For cadets participating in the ROTC scholarship program, the 104 R form plays a significant role in maintaining their scholarship eligibility. The form outlines the remaining credit hours needed for degree completion and confirms that the cadet is on track to fulfill the requirements. If the academic plan is approved, the scholarship will remain in force for the specified number of semesters, ensuring financial support for the cadet's education.
Providing inaccurate information on the 104 R form can lead to serious consequences for a cadet. It may affect their eligibility for the ROTC program, scholarship funding, and ultimately their commissioning in the Army. It is crucial for cadets to ensure that all details are correct and up to date. If there are discrepancies, it is advisable to address them promptly with the appropriate academic or ROTC advisors.
This is inaccurate. The form serves as a planning tool for both current and prospective students. It helps in assessing eligibility and academic progression for those interested in joining the Army ROTC program.
While the form is a critical component of the application process, it does not automatically secure a scholarship. Scholarship decisions are based on a variety of factors, including academic performance and leadership potential.
In fact, the form contains sensitive personal data. The Privacy Act of 1974 protects this information, ensuring it is used solely for the administration of the ROTC program.
This is misleading. Students must update the form regularly to reflect changes in their academic plans, course enrollments, or degree requirements. Continuous monitoring is essential for maintaining eligibility.
This is incorrect. Community college students can also participate in the ROTC program and must complete the 104 R form to outline their academic plans and ensure they meet the necessary requirements.
All academic majors can use the form. It is designed to accommodate various fields of study, ensuring that students from diverse backgrounds can plan their academic paths effectively.
While it primarily focuses on academic planning, the form also plays a role in assessing a student’s commitment to the Army ROTC program. It is a comprehensive tool that supports both educational and military objectives.
Incomplete Information: Failing to fill out all required fields can lead to delays. Each section of the form is important for evaluating eligibility.
Incorrect Dates: Entering the wrong date format can cause confusion. Use the MM/DD/YYYY format as specified in the instructions.
Missing Signatures: Not signing the form can result in rejection. Ensure both the student and the certifying official sign and date the document.
Incorrect Course Information: Listing courses inaccurately can affect academic progress assessments. Double-check course numbers, titles, and credits.
Ignoring the Review Section: Failing to confirm that all courses are required for degree completion may lead to misunderstandings. Always indicate whether the listed courses fulfill degree requirements.
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.
Page 2 of 3
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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