The 104 R form, also known as the Planned Academic Program Worksheet, is essential for students participating in the Army Senior ROTC program. This form collects vital information to ensure that students meet the academic requirements necessary for commissioning in the Army. Completing this form accurately is crucial for your eligibility, so be sure to fill it out by clicking the button below.
The 104 R form serves as a crucial tool for students participating in the Army Senior ROTC program, enabling them to outline their planned academic journey. This form, officially known as the Planned Academic Program Worksheet, captures essential details about the student’s academic major, credit hours, and grade point average (GPA). It is designed to ensure that students meet the necessary public law requirements for their remaining academic years. By documenting course selections, credit allocations, and grades, the form helps students and advisors track academic progress effectively. Additionally, it emphasizes the importance of voluntary disclosure of information, which is vital for determining eligibility and maintaining enrollment in the ROTC program. The completion of this form is not just a bureaucratic step; it represents a commitment to a structured academic path that supports the cadet's future in the Army. With signatures from both the student and an academic official, the 104 R form underscores the collaborative effort between the cadet and the institution to achieve educational and military goals.
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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Completing the 104 R form requires careful attention to detail. This form collects essential information for managing the Army Senior ROTC program and assessing eligibility for commissioning in the Army. Follow these steps to ensure accurate completion of the form.
What is the purpose of the 104 R form?
The 104 R form, known as the Planned Academic Program Worksheet, serves to gather essential information for managing the Army Senior ROTC program. It helps determine if a student meets the requirements for commissioning in the Army. The form outlines the academic plan for students, ensuring they are on track to complete their degree within the required timeframe.
Who needs to complete the 104 R form?
Students enrolled in the Army ROTC program are required to complete the 104 R form. This includes cadets who are pursuing their academic degrees while participating in ROTC. The form is particularly important for those who are scholarship recipients, as it helps verify that they are maintaining the necessary academic progress to continue receiving financial support.
What information is required on the 104 R form?
The form requires various details, including the student's name, academic major, credit hours, and grade point average (GPA). Additionally, students must list their courses, credit hours, and the grades they have achieved. This information allows the ROTC program to assess the student's academic standing and ensure they are meeting the requirements for their degree.
What happens if a student does not provide the requested information?
Providing information on the 104 R form is voluntary; however, it is crucial for determining a student's eligibility for acceptance, continuance, or discontinuance in the Army ROTC program. If a student chooses not to provide the necessary information, it may hinder their ability to participate in the program or receive financial assistance through scholarships.
How is the 104 R form submitted and who reviews it?
The completed 104 R form must be submitted to the appropriate ROTC officials at the student's academic institution. After submission, the form is reviewed by the Registrar and the Professor of Military Science, who will ensure that all information is accurate and meets the program's requirements. Their signatures on the form indicate that the student's academic plan has been officially evaluated.
Filling out the 104 R form can be straightforward, but many people make common mistakes that can lead to complications. One frequent error is not providing complete and accurate information in the NAME OF STUDENT section. Ensure that the last name, first name, and middle initial are filled in correctly. Any discrepancies can cause delays in processing and may affect eligibility.
Another mistake is failing to select the correct ACADEMIC MAJOR and corresponding CIP CODE. It’s important to verify that the major aligns with the degree program. This ensures that the academic plan meets the requirements set by the Army ROTC program. Double-checking this information can save time and prevent issues later.
Many individuals overlook the AS OF DATE field. This date should reflect the moment the form is completed. An incorrect date can lead to confusion regarding the student's current academic status. Always use the correct format (MM/DD/YYYY) to avoid any misunderstandings.
In the course listing section, students often forget to include all relevant courses or miscalculate CREDITS THAT COUNT TOWARDS ACADEMIC DEGREE. Each course should be listed with its corresponding credit hours and grades. Missing or incorrect information here can impact the assessment of academic progress.
Lastly, neglecting to obtain the necessary signatures can halt the processing of the form. Both the student and the certifying official must sign and date the form. Ensure that all signatures are collected before submission to avoid unnecessary delays.
The 104 R form, known as the Planned Academic Program Worksheet, is an essential document used in the Army Senior ROTC program. Alongside this form, several other documents and forms are commonly utilized to ensure a comprehensive understanding of a cadet's academic and military obligations. Here is a list of related forms that may be required.
Each of these forms plays a critical role in the administration of the ROTC program and the academic success of cadets. Understanding their purpose and requirements can help ensure that cadets remain on track with their educational and military goals.
When filling out the 104 R form, attention to detail is crucial. Here are five important dos and don'ts to keep in mind.
Here are some common misconceptions about the 104 R form:
Understanding the 104 R form is essential for students involved in the Army Senior ROTC program. Here are some key takeaways to keep in mind:
By keeping these points in mind, students can navigate the 104 R form more effectively and ensure they meet their academic and ROTC goals.