Fill a Valid 104 R Template Open Editor Here

Fill a Valid 104 R Template

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 students selected for commissioning in the Army. Completing this form is vital for determining eligibility and ensuring that academic requirements are met, so be sure to fill it out by clicking the button below.

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Form Overview

Fact Name Description
Authority The 104 R form is governed by Title 10, US Code 2101 and 2104.
Principal Purpose This form collects information necessary for managing the Army Senior ROTC program and processing selected students for commissioning.
Routine Uses It provides a projected academic plan to assess if the applicant meets the public law requirements for the remaining academic years.
Voluntary Disclosure Providing information is voluntary but essential for determining eligibility in the Army ROTC program.
Student Information The form requires details such as the student's name, academic major, and credit hours.
Course Details Students must list courses, credit hours, and grades for each term on the form.
Initials Requirement Students must initial and date beside each term to confirm counseling has occurred.
Review Section A review section confirms whether all courses listed are required for degree completion.
Signatures The form requires signatures from the student, registrar, and other certifying officials.

Common Questions

  1. What is the purpose of the 104 R form?

    The 104 R form, also known as the Planned Academic Program Worksheet, is used to gather important information about a student's academic plan. It helps to ensure that students in the Army Senior ROTC program meet the necessary requirements for commissioning. The form collects data about the student's major, credit hours, and grades to assess their academic progress.

  2. Who needs to fill out the 104 R form?

    This form must be completed by students participating in the Army ROTC program. It is particularly important for those who are nearing the end of their academic studies and need to confirm their eligibility for commissioning in the Army.

  3. What information is required on the form?

    The 104 R form requires several details, including:

    • Name of the student
    • Academic major
    • Credit hours completed
    • Grade Point Average (GPA)
    • Course details for each term, including course title, credit hours, and grades achieved

  4. How does the form affect my ROTC scholarship?

    If you are a scholarship participant, the 104 R form helps determine the duration of your scholarship. The information provided will confirm how many semesters of support you have remaining based on your academic progress and planned courses.

  5. What happens if I don’t provide the requested information?

    Providing the information on the 104 R form is voluntary, but not submitting it can impact your eligibility for the ROTC program. Without the necessary details, it may be difficult to assess whether you can continue in the program or meet the requirements for commissioning.

  6. When should I submit the 104 R form?

    You should submit the 104 R form as soon as you have your academic plan in place. It is important to do this before the start of your upcoming term to ensure that your academic progress is properly tracked and that you remain eligible for the ROTC program.

  7. Who reviews the completed form?

    The completed 104 R form is reviewed by the Registrar and an examiner of credentials or another certifying official at your institution. Their signature is required to confirm that the information provided is accurate and that you are on track to meet your degree requirements.

Documents used along the form

The 104 R form is a crucial document for students participating in the Army Senior ROTC program. It outlines their planned academic program and ensures that they meet the necessary requirements for commissioning. Along with this form, several other documents are often required to provide a comprehensive overview of a student's academic standing and eligibility. Below is a list of these forms and documents, each serving a specific purpose in the ROTC process.

  • ROTC Scholarship Application: This document is essential for students seeking financial assistance through ROTC scholarships. It collects personal, academic, and financial information to determine eligibility.
  • Cadet Enrollment Certificate: This form confirms a student's enrollment in the ROTC program. It serves as an official record for both the institution and the Army.
  • Child Support Texas Form: Understanding the texasdocuments.net/ is essential for navigating financial obligations and ensuring compliance with legal requirements.
  • Course Registration Form: Students must complete this form to officially register for their classes each term. It details the courses they plan to take and is often submitted to the registrar's office.
  • Academic Transcript: An official transcript provides a record of a student’s academic performance, including courses taken, grades received, and overall GPA. This document is crucial for evaluating a cadet's eligibility.
  • Degree Audit Report: This report outlines the courses a student has completed and those required for graduation. It helps ensure that cadets are on track to meet their degree requirements.
  • ROTC Cadet Command Form 145-1: This form is used to report cadet performance and progress. It includes evaluations and feedback from instructors, which are important for assessing a cadet's readiness.
  • Physical Fitness Assessment Record: Cadets must maintain physical fitness standards. This record documents their performance on fitness assessments, which are a requirement for ROTC participation.
  • Medical Examination Report: A medical exam is required to ensure that cadets meet health standards necessary for military service. This report must be submitted and approved before commissioning.
  • Statement of Understanding: This document outlines the responsibilities and commitments of the cadet regarding their ROTC participation. It ensures that cadets are aware of the program's requirements and expectations.
  • Service Obligation Agreement: This agreement specifies the length of service a cadet must fulfill after graduation. It is an essential component of the ROTC program, linking education with military service.

Each of these documents plays a vital role in the administration of the ROTC program. Together, they help ensure that cadets are adequately prepared for their academic and military commitments. Understanding the purpose of each document can facilitate a smoother experience for students navigating their ROTC journey.

Preview - 104 R Form

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:

 

 

 

 

 

 

 

 

 

Term:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

a. IDENTIFICATION (Check one):

Host

 

 

 

 

 

 

 

 

 

Curr GPA:

 

 

 

CUM:

 

 

Curr GPA:

 

 

CGPA:

 

 

 

 

 

Extension Center

 

 

 

a. Total required for degree:

 

 

1

 

 

Term:

 

 

 

 

 

 

 

 

 

Term:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Cross-Enrolled

 

 

 

(1) ROTC Hours that do not count:

 

 

 

 

 

Curr GPA:

 

 

 

CUM:

 

 

Curr GPA:

 

 

CGPA:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(2) Total Hours Rqd for NAPS:

 

 

 

 

 

Term:

 

 

 

 

 

 

 

 

 

Term:

 

 

 

 

 

 

 

 

 

 

 

b. HOST SCHOOL

 

 

c. HOST FICE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Normal Academic Progression Standard

 

 

 

 

 

Curr GPA:

 

 

 

CUM:

 

 

Curr GPA:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

CGPA:

 

 

 

 

 

 

 

 

 

 

b. Credits toward degree Comp to date:

 

 

 

 

 

Term:

 

 

 

 

 

 

 

 

 

Term:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

c. Transfer Credits accepted:

 

 

 

 

 

Curr GPA:

 

 

 

CUM:

 

 

Curr GPA:

 

 

CGPA:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

d. Remaining for Degree:

 

 

 

 

 

Term:

 

 

 

 

 

 

 

 

 

Term:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

e. Number of authorized S/Qs:

 

 

 

 

 

Curr GPA:

 

 

 

CUM:

 

 

 

 

Curr GPA:

 

 

CGPA:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

7.TERM, YEAR, COURSE NUMBER, COURSE TITLE, COURSE CREDIT HOURS, CREDITS THAT COUNT TOWARDS ACADEMIC DEGREE, AND ACHIEVED GRADES.

a.

Term:

 

Year:

No.

Course Title

Hrs. Cts. Grd.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Total Term Hours:

d.

Term:

 

Year:

No.

Course Title

Hrs. Cts. Grd.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Total Term Hours:

b.

 

Term:

 

Year:

 

No.

Course Title

Hrs. Cts. Grd.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Total Term Hours:

e.

Term:

 

Year:

No.

 

Course Title

Hrs. Cts. Grd.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Total Term Hours:

c.

Term:

 

Year:

No.

Course Title

Hrs. Cts. Grd.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Total Term Hours:

f.

Term:

 

Year:

 

 

 

No.

Course Title

Hrs. Cts. Grd.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Total Term Hours:

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

PLANNED ACADEMIC PROGRAM WORKSHEET

For use of this form, see USACC Pam 145-4, the proponent agency is ATCC-PA-C

7.TERM, YEAR, COURSE NUMBER, COURSE TITLE, COURSE CREDIT HOURS, CREDITS THAT COUNT TOWARDS ACADEMIC DEGREE, AND ACHIEVED GRADES. (CONTINUED)

g.

Term:

 

Year:

No.

Course Title

Hrs. Cts. Grd.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Total Term Hours:

h.

Term:

 

Year:

No.

Course Title

Hrs. Cts. Grd.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Total Term Hours:

i.

Term:

 

Year:

No.

Course Title

Hrs. Cts. Grd.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Total Term Hours:

 

j.

 

 

 

k.

 

 

 

l.

 

Term:

 

Year:

 

Term:

 

Year:

 

Term:

 

Year:

No.

Course Title

Hrs. Cts. Grd.

 

No.

Course Title

Hrs. Cts. Grd.

 

No.

Course Title

Hrs. Cts. Grd.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Total Term Hours:

 

 

 

 

 

Total Term Hours:

 

 

 

 

 

Total Term Hours:

 

 

 

 

 

 

m.

 

 

 

 

 

 

n.

 

 

 

 

 

o.

 

 

 

 

 

Term:

 

 

Year:

 

Term:

 

 

Year:

 

Term:

 

 

Year:

 

 

No.

Course Title

Hrs.

Cts.

Grd.

 

No.

 

Course Title

Hrs.

Cts.

Grd.

 

No.

Course Title

Hrs.

Cts.

Grd.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Total Term Hours:

 

 

 

 

 

Total Term Hours:

 

 

 

 

 

Total Term Hours:

 

 

 

 

 

 

 

 

 

 

 

 

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.

DATE: (MM/DD/YYYY)

 

 

 

 

 

USACC Form 104-R, SEP 13

Page 2 of 3

 

 

 

PLANNED ACADEMIC PROGRAM WORKSHEET

 

 

 

For use of this form, see USACC Pam 145-4, the proponent agency is ATCC-PA-C

 

 

 

 

 

 

 

 

 

 

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)

(Date) (MM/DD/YYYY)

(PROFESSOR OF MILITARY SCIENCE SIGNATURE)

USACC Form 104-R, SEP 13

Page 3 of 3

Common mistakes

Completing the 104 R form can seem straightforward, but many individuals make common mistakes that can lead to delays or complications in their application process. Here are nine frequent errors to watch out for when filling out this important document.

One of the most common mistakes is failing to provide accurate personal information. This includes the student’s name, academic major, and the date of form preparation. Even a small typo can create confusion and may lead to processing delays. Double-checking this information before submission can save time and hassle.

Another frequent error involves neglecting to include the correct CIP code. The Classification of Instructional Programs (CIP) code is essential for identifying the student’s academic major. If this code is missing or incorrect, it can affect the evaluation of the academic program.

Many applicants also forget to indicate whether they are enrolled in a host school or an extension center. This detail is crucial for determining the appropriate academic standards and requirements applicable to the student’s program. Be sure to check the correct box to avoid any misunderstandings.

Inaccuracies in reporting credit hours and grade point averages (GPA) are also common. Students often miscalculate or misreport their current GPA or the total required credit hours for their degree. It’s important to ensure that these figures are accurate, as they play a significant role in assessing academic progress.

Another mistake is failing to list all relevant courses under the course section. Each course should include the term, year, course number, title, credit hours, and grades achieved. Omitting any of this information can lead to an incomplete application, which may delay processing.

Some applicants overlook the necessity of having their initials and dates beside each term, indicating that they have been counseled. This step confirms that the student is aware of their academic plan and is crucial for maintaining transparency throughout the process.

Additionally, failing to review whether all courses listed are required for degree completion can be problematic. There is a specific section that asks if all courses are necessary. If not, exceptions must be noted on the back of the form. Ignoring this requirement can lead to complications in fulfilling academic obligations.

Another common oversight is the signature section. Students often forget to sign and date the form, as well as obtain the necessary signatures from the registrar or other certifying officials. This step is essential for validating the application and ensuring that it is processed correctly.

Finally, many applicants do not take the time to thoroughly review the entire form before submission. It’s easy to miss small details or errors when rushing through the process. A careful review can help catch mistakes that could otherwise lead to delays in processing the application.

By being mindful of these common mistakes, individuals can ensure a smoother experience when completing the 104 R form. Attention to detail can make a significant difference in the outcome of their application.

Similar forms

The 104 R form, known as the Planned Academic Program Worksheet, shares similarities with several other documents used in academic settings. Here are nine documents that are comparable to the 104 R form, along with explanations of how they are similar:

  • Degree Audit Report: This document outlines a student's completed and remaining coursework required for graduation, similar to how the 104 R form tracks academic progress towards a degree.
  • Academic Plan: An academic plan details the courses a student intends to take over a specific period. Like the 104 R form, it helps ensure that the student meets all necessary requirements for their degree.
  • Course Registration Form: This form allows students to register for classes each semester. It is similar to the 104 R form in that both require students to provide information about their academic courses.
  • Transcript: A transcript provides a record of a student's academic performance. The 104 R form also includes grades and credit hours, making them both essential for tracking academic achievements.
  • Transfer Credit Evaluation: This document assesses which credits from other institutions can be applied towards a degree. It relates to the 104 R form's focus on credits needed for degree completion.
  • Financial Aid Application: This form gathers information about a student’s academic program to determine eligibility for financial aid. Both documents aim to support students in their academic journey.
  • Scholarship Application: Scholarship applications often require details about a student’s academic plans and achievements, similar to the information requested in the 104 R form.
  • Employment Verification Form: This important document confirms an individual's employment status and can be essential for processes such as loan applications; more details can be found at floridaformspdf.com/printable-employment-verification-form/.
  • Academic Advising Worksheet: This worksheet is used during advising sessions to help students plan their courses. Like the 104 R form, it assists in ensuring that students stay on track for graduation.
  • Enrollment Verification Form: This form confirms a student's enrollment status and academic progress. It is similar to the 104 R form as both documents provide essential information for academic administration.

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