Blank 104 R Form

When filling out the 104 R form, there are specific actions to take and avoid to ensure accuracy and compliance. The following list outlines what to do and what not to do:

• Do provide your full name as it appears on official documents.
• Do specify your academic major clearly, including the CIP code.
• Do check the date of form preparation and ensure it is accurate.
• Do list all relevant courses and grades, ensuring that credits are accurately recorded.
• Do have the student initial and date beside each term to confirm counseling.
• Don't leave any required fields blank; incomplete forms may delay processing.
• Don't use abbreviations or informal language; clarity is essential.
• Don't forget to sign and date the form at the end to validate the information provided.
• Don't provide false information; doing so can have serious consequences for your ROTC status.

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

   The 104 R form, officially known as the Planned Academic Program Worksheet, serves to collect and provide essential information for managing the Army Senior ROTC program. This form helps determine if selected students meet the necessary academic requirements for commissioning in the Army.

2. Who is required to complete the 104 R form?

   Students enrolled in the Army ROTC program must complete the 104 R form. It is particularly important for those who are nearing the completion of their academic degree and wish to ensure they meet the necessary criteria for commissioning.

3. What information is collected on the 104 R form?

   The form collects various details, including:

   • Name of the student
   • Academic major and CIP code
   • Credit hours and grade point average (GPA)
   • Courses taken and grades achieved
   • Projected academic plan for remaining terms
4. How does the 104 R form impact a student's eligibility?

   Completing the 104 R form is crucial for determining a student's eligibility for acceptance, continuation, or discontinuation in the Army ROTC program. The information provided helps assess whether the student meets the public law requirements for their remaining academic years.

5. What is the significance of the privacy act statement included in the form?

   The privacy act statement outlines the authority under which the form is collected and the purpose of gathering this information. It emphasizes the importance of voluntary disclosure and informs students about the implications of not providing the required information.

6. What should a student do if they have questions while filling out the form?

   If a student has questions or needs assistance while completing the 104 R form, they should consult their academic advisor or the ROTC program coordinator. These individuals can provide guidance and clarify any uncertainties regarding the form.

7. What happens after the 104 R form is submitted?

   Once the 104 R form is completed and submitted, it will be reviewed by the appropriate academic and ROTC officials. They will evaluate the information to ensure the student is on track to meet their academic requirements and to confirm their eligibility for commissioning in the Army.