The 104 R form is a Planned Academic Program Worksheet used by the Army Senior ROTC program. It collects essential information to ensure that students meet the necessary academic requirements for commissioning in the Army. Completing this form is vital for your academic planning and ROTC participation.
Start filling out the form by clicking the button below.
The 104 R form, known as the Planned Academic Program Worksheet, plays a crucial role in the administration of the Army Senior ROTC program. Designed to facilitate the tracking and management of selected students aiming for commissioning in the Army, this form collects essential information regarding an individual's academic journey. It requires details such as the student's name, academic major, and current grade point average, alongside a structured outline of courses taken, credits earned, and grades achieved. By providing a comprehensive view of the student’s academic progress, the 104 R form ensures that candidates meet the necessary public law requirements for their remaining academic years. The form also emphasizes the importance of voluntary disclosure, as the information provided is vital for determining eligibility for acceptance and continuation in the ROTC program. Furthermore, it includes sections for both student and institutional signatures, reinforcing the collaborative effort in achieving academic and military goals. Understanding the intricacies of this form is essential for any prospective ROTC participant, as it directly impacts their path toward a successful military career.
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
Completing the 104 R form is essential for students participating in the Army Senior ROTC program. This form collects important information about your academic plans, ensuring that you meet the necessary requirements for commissioning in the Army. Follow these steps carefully to fill out the form accurately.
Once the form is filled out, it should be submitted according to your institution's guidelines. Ensure all information is accurate to avoid any issues with your ROTC program participation.
The 104 R form, also known as the Planned Academic Program Worksheet, serves to collect information necessary for managing the Army Senior ROTC program. It helps determine if a student meets the requirements for commissioning in the Army by outlining their academic plans for the remaining years of their degree.
This form is intended for students enrolled in the Army ROTC program. Specifically, it is used by cadets who are planning their academic courses to ensure they meet the necessary requirements for graduation and commissioning.
Several key pieces of information must be provided, including:
If a cadet is a participant in an ROTC scholarship program, the 104 R form indicates the number of semesters the scholarship will remain in effect. It is crucial for maintaining eligibility for financial support throughout their academic journey.
Providing information on the 104 R form is voluntary but essential. Without it, the ROTC program may not be able to determine the student's eligibility for acceptance, continuance, or discontinuance in the program. This could ultimately affect their academic and career goals.
The form should be completed and submitted as soon as the student has outlined their academic plan for the upcoming terms. Timely submission ensures that the ROTC program can assess the student's progress and make necessary adjustments to their academic trajectory.
If a student needs to make changes to their academic plan after submitting the form, they should contact their ROTC advisor immediately. Adjustments may need to be documented, and the advisor can guide the student on how to update their information appropriately.
Failing to provide the correct name of the student. Ensure the name is written in the format of last name, first name, and middle initial.
Omitting the academic major. This information is essential for processing the application accurately.
Incorrectly entering the CIP code. This code must match the academic major to avoid delays in processing.
Not updating the as of date. The date should reflect when the form is prepared, formatted as MM/DD/YYYY.
Misrepresenting credit hours completed. All credit hours must be accurately reported to reflect the student's progress.
Neglecting to indicate the grade point average (GPA). Both current and cumulative GPAs are necessary for assessment.
Failing to check the correct semester or quarter option. This choice impacts the academic planning process.
Not signing or dating the form in the student initials and date section. This step confirms that the student has been counseled.
Overlooking the review section. Ensure to indicate whether all courses listed are required for degree completion.
The 104 R form is essential for students in the Army Senior ROTC program, as it helps outline their academic plans and eligibility for commissioning. Alongside this form, several other documents are often required to ensure a comprehensive understanding of a student's academic trajectory. Below is a list of these related forms and documents.
Each of these documents plays a critical role in supporting the student's journey through the ROTC program. Together, they ensure that all requirements are met and that students are adequately prepared for their future roles in the Army.
The 104 R form is similar to the Academic Advising Worksheet used by many colleges and universities. Both documents serve as a guide for students to outline their academic plans and track their progress towards degree completion. The Academic Advising Worksheet typically includes sections for listing courses taken, credits earned, and remaining requirements, much like the 104 R form. This helps students and academic advisors ensure that all necessary courses are completed in a timely manner, facilitating a smoother path to graduation.
Another document that resembles the 104 R form is the Degree Audit Report (DAR). The DAR is an official record provided by educational institutions that details a student’s completed courses, credits, and remaining requirements for graduation. Similar to the 104 R form, it helps students visualize their academic journey and understand what is needed to achieve their degree. This report is often generated automatically by the school’s system, making it a convenient tool for both students and advisors.
The Transfer Credit Evaluation form also shares similarities with the 104 R form. This document is used when a student wishes to transfer credits from another institution. It outlines which courses will be accepted and how they will apply to the student’s current degree program. Like the 104 R form, it requires careful attention to detail and helps ensure that students are on track to meet their academic goals while considering previously earned credits.
Similarly, the Enrollment Verification form serves a comparable purpose. This document is often requested by students to confirm their enrollment status for various reasons, such as applying for loans or scholarships. It details the student’s current courses and academic standing, much like the 104 R form. Both documents provide essential information that supports the student’s academic journey and facilitates communication with external parties.
Finally, the Course Registration form aligns with the 104 R form in that it helps students plan their academic schedules. This form is used each semester to select courses that will count toward their degree. Like the 104 R form, it requires students to consider their academic progress and make informed decisions about their course load. Both forms emphasize the importance of careful planning in achieving educational objectives.
Filling out the 104 R form is a crucial step for students participating in the Army Senior ROTC program. To ensure accuracy and compliance, here’s a list of dos and don’ts to guide you through the process.
By following these guidelines, you can help ensure that your 104 R form is completed correctly and submitted on time. Your future in the Army ROTC program depends on it!
Understanding the 104 R form is essential for students involved in the Army Senior ROTC program. However, several misconceptions often arise regarding its purpose and use. Here are six common misunderstandings:
Clearing up these misconceptions can help students navigate their academic and military paths more effectively. Being informed is the first step toward success in the ROTC program.
Filling out the 104 R form is a crucial step in the Army Senior ROTC program. Here are key takeaways to keep in mind:
By following these takeaways, you can navigate the 104 R form process more effectively and stay on track for your academic goals.