The 104 R form is a Planned Academic Program Worksheet used in the Army Senior ROTC program. This form collects essential information to help manage and process selected students for commissioning in the Army. It outlines academic requirements and tracks progress toward degree completion.
The 104 R form is a crucial document for students participating in the Army Senior ROTC program. This Planned Academic Program Worksheet helps both students and advisors track academic progress and ensure compliance with public law requirements for commissioning. The form collects essential data, including the student’s name, academic major, and credit hours, while also requiring a detailed breakdown of courses taken and grades achieved. It aims to project an academic plan that confirms whether the student meets the necessary criteria for the remaining two years of study. By voluntarily providing this information, students can demonstrate their eligibility for acceptance or continuation in the program. The form also includes sections for signatures from both the student and the registrar, affirming the accuracy of the academic plan outlined. Timely completion of the 104 R form is vital, as it directly impacts a student's academic trajectory and ROTC scholarship status.
When filling out the 104 R form, it is important to be thorough and accurate. Here are eight things to keep in mind:
The 104 R form is essential for students in the Army Senior ROTC program. It helps track academic progress and ensures compliance with public law.
Filling out the form accurately is crucial. It requires information such as the student's name, academic major, and credit hours.
Students must provide their Grade Point Average (GPA) and the total required credit hours for their degree. This information helps assess eligibility for continuation in the program.
Each term, students need to list their courses, credit hours, and grades. This detailed record is vital for monitoring academic progress.
It is important for students to initial and date beside each term. This indicates they have received counseling regarding their academic plan.
Reviewing the courses is necessary. Students must confirm that all listed courses are required for their degree completion.
Both the student and the registrar must sign the form. Their signatures verify the accuracy of the information provided.
Understanding the implications of the information is key. The form plays a significant role in determining eligibility for ROTC scholarships.
Finally, be aware of deadlines. Timely submission of the 104 R form is essential to ensure that students remain in good standing within the ROTC program.
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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
Page 1 of 3
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)
Page 3 of 3
The 104 R form, officially known as the Planned Academic Program Worksheet, is an essential document for students in the Army Senior ROTC program. However, several misconceptions surround its purpose and usage. Below are six common misunderstandings, along with clarifications to help individuals better understand this important form.
This is not true. The 104 R form is designed for all ROTC cadets, regardless of their academic standing. It helps outline a clear academic plan to ensure that all students can meet their degree requirements and ROTC obligations.
While the form is important for scholarship participants, it does not guarantee funding. Scholarships depend on various factors, including academic performance and ROTC program requirements.
This form may need to be updated regularly. As students progress through their academic careers, changes in courses or degree requirements may necessitate revisions to the planned academic program.
While academic advisors play a crucial role, students are encouraged to take an active part in completing the form. Their involvement ensures that the academic plan accurately reflects their goals and aspirations.
On the contrary, the 104 R form is vital. It outlines the courses necessary for degree completion, helping students stay on track for graduation.
Failure to submit the form can have serious implications. It may affect a student's eligibility for the ROTC program, scholarships, and ultimately their ability to graduate on time.
The 104 R form, known as the Planned Academic Program Worksheet, serves a specific purpose within the Army Senior ROTC program. Several other documents share similarities with it, particularly in their focus on academic planning and eligibility. Here are four documents that resemble the 104 R form: