usacc form 104-r, sep 13...usacc form 104-r, sep 13 page 1 of 3for use of this form, see usacc pam...

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1. NAME OF STUDENT (LAST, FIRST, MI) 2. ACADEMIC MAJOR 3. AS OF DATE (MM/DD/YYYY) a. IDENTIFICATION (Check one): Host CUM: CGPA: CUM: CGPA: CUM: CGPA: CUM: CGPA: CUM: CGPA: 7. a. b. Term: Year: Term: Year: Course Title Hrs. Cts. Grd. No. Course Title Hrs. Cts. Grd. Hrs. Cts. Grd. Total Term Hours: Total Term Hours: d. e. (Have the student initial and date beside each term to indicate they have been counseled) USACC Form 104-R, SEP 13 Page 1 of 3 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 Curr GPA: 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 c. TERM, YEAR, COURSE NUMBER, COURSE TITLE, COURSE CREDIT HOURS, CREDITS THAT COUNT TOWARDS ACADEMIC DEGREE, AND ACHIEVED GRADES. Curr GPA: Curr GPA: Term: Term: Term: Term: 1. AUTHORITY: Title 10, US Code 2101 and 2104 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. Term: Curr GPA: Term: Term: Curr GPA: 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. Total Term Hours: Curr GPA: Curr GPA: Curr GPA: Term: Curr GPA: Term: Term: f. Curr GPA: TERM 7: TERM 8: TERM 9: 8. STUDENT INITIALS & DATE: TERM 2: TERM 4: TERM 5: TERM 3: TERM 1: TERM 6: (1) ROTC Hours that do not count: (Date of form preparation) Extension Center Cross-Enrolled b. HOST SCHOOL 5. CREDIT HOURS 6. GRADE POINT AVERAGE (GPA) Course Title No. Term: Year: Term: Year: No. Course Title Hrs. Cts. Grd. Total Term Hours: Term: Year: No. Course Title Hrs. Cts. Grd. Total Term Hours: Term: Year: No. Course Title Grd. Total Term Hours: Cts. Hrs. 2a. CIP CODE No. c. HOST FICE 4. ACADEMIC SCHOOL b. Credits toward degree Comp to date: Normal Academic Progression Standard c. Transfer Credits accepted: d. Remaining for Degree: (2) Total Hours Rqd for NAPS: a. Total required for degree: e. Number of authorized S/Qs: Select Semester or Quarter (S/Q) PLANNED ACADEMIC PROGRAM WORKSHEET

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  • 1. NAME OF STUDENT (LAST, FIRST, MI) 2. ACADEMIC MAJOR 3. AS OF DATE (MM/DD/YYYY)

    a. IDENTIFICATION (Check one): Host CUM: CGPA:

    CUM: CGPA:

    CUM: CGPA:

    CUM: CGPA:

    CUM: CGPA:

    7.a. b.

    Term: Year: Term: Year:Course Title Hrs. Cts. Grd. No. Course Title Hrs. Cts. Grd. Hrs. Cts. Grd.

    Total Term Hours: Total Term Hours:d. e.

    (Have the student initial and date beside each term to indicate they have been counseled)

    USACC Form 104-R, SEP 13 Page 1 of 3

    For use of this form, see USACC Pam 145-4, the proponent agency is ATCC-PA-CDATA REQUIRED BY PRIVACY ACT STATEMENT OF 1974

    Curr GPA:

    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

    c.

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

    Curr GPA:

    Curr GPA:

    Term:

    Term: Term:

    Term:

    1. AUTHORITY: Title 10, US Code 2101 and 2104

    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.

    Term:

    Curr GPA:

    Term:

    Term:

    Curr GPA:

    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.

    Total Term Hours:

    Curr GPA:

    Curr GPA:

    Curr GPA:

    Term:

    Curr GPA:

    Term:

    Term:

    f.

    Curr GPA:

    TERM 7:TERM 8:TERM 9:

    8. STUDENT INITIALS & DATE:

    TERM 2:

    TERM 4:TERM 5:

    TERM 3:

    TERM 1:

    TERM 6:

    (1) ROTC Hours that do not count:

    (Date of form preparation)

    Extension Center

    Cross-Enrolled

    b. HOST SCHOOL

    5. CREDIT HOURS 6. GRADE POINT AVERAGE (GPA)

    Course TitleNo.Term: Year:

    Term: Year:No. Course Title Hrs. Cts. Grd.

    Total Term Hours:

    Term: Year:No. Course Title Hrs. Cts. Grd.

    Total Term Hours:

    Term: Year:No. Course Title Grd.

    Total Term Hours:

    Cts.Hrs.

    2a. CIP CODE

    No.

    c. HOST FICE

    4. ACADEMIC SCHOOL

    b. Credits toward degree Comp to date:

    Normal Academic Progression Standard

    c. Transfer Credits accepted: d. Remaining for Degree:

    (2) Total Hours Rqd for NAPS:

    a. Total required for degree:

    e. Number of authorized S/Qs:

    Select Semester or Quarter (S/Q)

    PLANNED ACADEMIC PROGRAM WORKSHEET

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

    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:

    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:

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

    Completion should result in

    Yes No (if no, list exceptions on reverside of this form). degree, during (Month, Year):

  • 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

    designed to meet the requirments of a degree; that the degree to be attained is the culmination of an

    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)

    (Date) (MM/DD/YYYY)

    USACC Form 104-R, SEP 13 Page 3 of 3

    STATEMENT OF UNDERSTANDING

    PLANNED ACADEMIC PROGRAM WORKSHEETFor use of this form, see USACC Pam 145-4, the proponent agency is ATCC-PA-C

    (FULL NAME, Last, First, MI) (Name of University or College)

    (PROFESSOR OF MILITARY SCIENCE SIGNATURE)

    (Type of Degree)

    (CADET SIGNATURE)

    9.0.0.2.20120627.2.874785

    a. IDENTIFICATION (Check one):

    CUM:

    CGPA:

    CUM:

    CGPA:

    CUM:

    CGPA:

    CUM:

    CGPA:

    CUM:

    CGPA:

    7.

    a.

    b.

    Term:

    Year:

    Term:

    Year:

    Course Title

    Hrs.

    Cts.

    Grd.

    No.

    Course Title

    Hrs.

    Cts.

    Grd.

    Hrs.

    Cts.

    Grd.

    Total Term Hours:

    Total Term Hours:

    d.

    e.

    (Have the student initial and date beside each

    term to indicate they have been counseled)

    USACC Form 104-R, SEP 13

    Page 1 of 3

    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

    Curr GPA:

    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

    c.

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

    Curr GPA:

    Curr GPA:

    Term:

    Term:

    Term:

    Term:

    1.

    AUTHORITY:

    Title 10, US Code 2101 and 2104

    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.

    Term:

    Curr GPA:

    Term:

    Term:

    Curr GPA:

    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.

    Total Term Hours:

    Curr GPA:

    Curr GPA:

    Curr GPA:

    Term:

    Curr GPA:

    Term:

    Term:

    f.

    Curr GPA:

    TERM 7:

    TERM 8:

    TERM 9:

    8. STUDENT INITIALS & DATE:

    TERM 2:

    TERM 4:

    TERM 5:

    TERM 3:

    TERM 1:

    TERM 6:

    (1) ROTC Hours that do not count:

    (Date of form preparation)

    5. CREDIT HOURS

    6. GRADE POINT AVERAGE (GPA)

    Course Title

    No.

    Term:

    Year:

    Term:

    Year:

    No.

    Course Title

    Hrs.

    Cts.

    Grd.

    Total Term Hours:

    Term:

    Year:

    No.

    Course Title

    Hrs.

    Cts.

    Grd.

    Total Term Hours:

    Term:

    Year:

    No.

    Course Title

    Grd.

    Total Term Hours:

    Cts.

    Hrs.

    No.

    b. Credits toward degree Comp to date:

    Normal Academic Progression Standard

    c. Transfer Credits accepted:

    d. Remaining for Degree:

    (2) Total Hours Rqd for NAPS:

    a. Total required for degree:

    e. Number of authorized S/Qs:

    Select Semester or Quarter (S/Q)

    PLANNED ACADEMIC PROGRAM WORKSHEET

    7.

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

    g.

    h.

    i.

    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:

    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:                    

    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

     degree, during (Month, Year):

    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

    designed to meet the requirments of a

    degree; that the degree to be attained is the culmination of an

    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)

    (Date) (MM/DD/YYYY)

    USACC Form 104-R, SEP 13

    Page 3 of 3

    STATEMENT OF UNDERSTANDING

    PLANNED ACADEMIC PROGRAM WORKSHEET

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

    (FULL NAME, Last, First, MI)

    (Name of University or College)

    (PROFESSOR OF MILITARY SCIENCE SIGNATURE)

    (Type of Degree)

    (CADET SIGNATURE)

    Name: Acad_Major: Date: Host: 0ExtensionCtr: 0Cross_Enrolled: 0T8: 8T8a: 1HostSchool: T8b: T8c: T8d: T8e: T8f: T8g: T8h: No.: T47: T47a: T47b: T47c: T47d: T47e: T47f: T47g: T47h: T48: T48a: T48b: T48c: T48d: T48e: T48f: T48g: T48h: T49: T49a: T49b: T49c: T49d: T49e: T49f: T49h: CourseTitle: T47a_1: T47b_1: T47c_1: T47d_1: T47e_1: T47f_1: T47g_1: T47h_1: T47i_1: T47a_2: T47b_2: T47c_2: T47d_2: T47e_2: T47f_2: T47g_2: T47h_2: T47i_2: T47a_3: T47b_3: T47c_3: T47d_3: T47e_3: T47f_3: T47g_3: T47h_3: T47a_4: T47b_4: T47c_4: T47d_4: T47e_4: T47f_4: T47g_4: T47h_4: T47i_3: T47i_4: Term: CurrentGPA: CGPA: Term2: CurrGPA2: CGPA2: Term3: CurrGPA3: CGPA3: Term4: CurrGPA4: CGPA4: Term5: CurrGPA5: CGPA5: Term6: CurrGPA6: CGPA6: Term7: CurrGPA7: CGPA7: CGPA8: CurrGPA8: Term8: Term9: Term10: CurrGPA9: CGPA9: CGPA10: CurrGPA10: T49g: Year_a: T47a_5: T47b_5: T47c_5: T47d_5: T47e_5: T47f_5: T47g_5: T47h_5: T47i_5: T48a_1: T48b_1: T48c_1: T48d_1: T48e_1: T48f_1: T48g_1: T48h_1: T48i_1: Term_d: Year_d: T47a_7: T47b_7: T47c_7: T47d_7: T47e_7: T47f_7: T47g_7: T47h_7: T47i_7: T48a_2: T48b_2: T48c_2: T48d_2: T48e_2: T48f_2: T48g_2: T48h_2: T48i_2: Term_e: Year_e: T47a_8: T47b_8: T47c_8: T47d_8: T47e_8: T47f_8: T47g_8: T47h_8: T47i_8: T48a_3: T48b_3: T48c_3: T48d_3: T48e_3: T48f_3: T48g_3: T48h_3: T48i_3: Term_f: Year_f: Term_a: Year_b: Year_c: Term_c: 99.9999: Term_1: Term_2: Term_3: Term_4: Term_5: Term_6: Term_7: Term_8: Term_9: HostFice: AcadSchool: No._Row_1: Course Title_Row_1: Hrs._Row_1: Cts._Row_1: Grd._Row_1: No._Row_2: Course Title_Row_2: Hrs._Row_2: Cts._Row_2: Grd._Row_2: No._Row_3: Course Title_Row_3: Hrs._Row_3: Cts._Row_3: Grd._Row_3: No._Row_4: Course Title_Row_4: Hrs._Row_4: Cts._Row_4: Grd._Row_4: No._Row_5: Course Title_Row_5: Hrs._Row_5: Cts._Row_5: Grd._Row_5: No._Row_6: Course Title_Row_6: Hrs._Row_6: Cts._Row_6: Grd._Row_6: No._Row_7: Course Title_Row_7: Hrs._Row_7: Cts._Row_7: Grd._Row_7: Grd._0: No._Row_1: Course Title_Row_1: Hrs._Row_1: Cts._Row_1: Grd._Row_1: No._Row_2: Course Title_Row_2: Hrs._Row_2: Cts._Row_2: Grd._Row_2: No._Row_3: Course Title_Row_3: Hrs._Row_3: Cts._Row_3: Grd._Row_3: No._Row_4: Course Title_Row_4: Hrs._Row_4: Cts._Row_4: Grd._Row_4: No._Row_5: Course Title_Row_5: Hrs._Row_5: Cts._Row_5: Grd._Row_5: No._Row_6: Course Title_Row_6: Hrs._Row_6: Cts._Row_6: Grd._Row_6: No._Row_7: Course Title_Row_7: Hrs._Row_7: Cts._Row_7: Grd._Row_7: Grd._0: No._Row_1: Course Title_Row_1: Hrs._Row_1: Cts._Row_1: Grd._Row_1: No._Row_2: Course Title_Row_2: Hrs._Row_2: Cts._Row_2: Grd._Row_2: No._Row_3: Course Title_Row_3: Hrs._Row_3: Cts._Row_3: Grd._Row_3: No._Row_4: Course Title_Row_4: Hrs._Row_4: Cts._Row_4: Grd._Row_4: No._Row_5: Course Title_Row_5: Hrs._Row_5: Cts._Row_5: Grd._Row_5: No._Row_6: Course Title_Row_6: Hrs._Row_6: Cts._Row_6: Grd._Row_6: No._Row_7: Course Title_Row_7: Hrs._Row_7: Cts._Row_7: Grd._Row_7: Grd._0: No._Row_1: Course Title_Row_1: Hrs._Row_1: Cts._Row_1: Grd._Row_1: No._Row_2: Course Title_Row_2: Hrs._Row_2: Cts._Row_2: Grd._Row_2: No._Row_3: Course Title_Row_3: Hrs._Row_3: Cts._Row_3: Grd._Row_3: No._Row_4: Course Title_Row_4: Hrs._Row_4: Cts._Row_4: Grd._Row_4: No._Row_5: Course Title_Row_5: Hrs._Row_5: Cts._Row_5: Grd._Row_5: No._Row_6: Course Title_Row_6: Hrs._Row_6: Cts._Row_6: Grd._Row_6: No._Row_7: Course Title_Row_7: Hrs._Row_7: Cts._Row_7: Grd._Row_7: Grd._0: No._Row_1: Course Title_Row_1: Hrs._Row_1: Cts._Row_1: Grd._Row_1: No._Row_2: Course Title_Row_2: Hrs._Row_2: Cts._Row_2: Grd._Row_2: No._Row_3: Course Title_Row_3: Hrs._Row_3: Cts._Row_3: Grd._Row_3: No._Row_4: Course Title_Row_4: Hrs._Row_4: Cts._Row_4: Grd._Row_4: No._Row_5: Course Title_Row_5: Hrs._Row_5: Cts._Row_5: Grd._Row_5: No._Row_6: Course Title_Row_6: Hrs._Row_6: Cts._Row_6: Grd._Row_6: No._Row_7: Course Title_Row_7: Hrs._Row_7: Cts._Row_7: Grd._Row_7: Grd._0: No._Row_1: Course Title_Row_1: Hrs._Row_1: Cts._Row_1: Grd._Row_1: No._Row_2: Course Title_Row_2: Hrs._Row_2: Cts._Row_2: Grd._Row_2: No._Row_3: Course Title_Row_3: Hrs._Row_3: Cts._Row_3: Grd._Row_3: No._Row_4: Course Title_Row_4: Hrs._Row_4: Cts._Row_4: Grd._Row_4: No._Row_5: Course Title_Row_5: Hrs._Row_5: Cts._Row_5: Grd._Row_5: No._Row_6: Course Title_Row_6: Hrs._Row_6: Cts._Row_6: Grd._Row_6: No._Row_7: Course Title_Row_7: Hrs._Row_7: Cts._Row_7: Grd._Row_7: Grd._0: No._Row_4: Course Title_Row_4: Hrs._Row_4: Cts._Row_4: Grd._Row_4: No._Row_5: Course Title_Row_5: Hrs._Row_5: Cts._Row_5: Grd._Row_5: No._Row_6: Course Title_Row_6: Hrs._Row_6: Cts._Row_6: Grd._Row_6: No._Row_7: Course Title_Row_7: Hrs._Row_7: Cts._Row_7: Grd._Row_7: Grd._0: No._Row_1: Course Title_Row_1: Hrs._Row_1: Cts._Row_1: Grd._Row_1: No._Row_1: Course Title_Row_1: Hrs._Row_1: Cts._Row_1: Grd._Row_1: No._Row_2: Course Title_Row_2: No._Row_2: Course Title_Row_2: Hrs._Row_2: Cts._Row_2: Grd._Row_2: Hrs._Row_2: Cts._Row_2: Grd._Row_2: No._Row_3: Course Title_Row_3: No._Row_3: Course Title_Row_3: Hrs._Row_3: Cts._Row_3: Grd._Row_3: Hrs._Row_3: Cts._Row_3: Grd._Row_3: No._Row_4: Course Title_Row_4: Hrs._Row_4: Cts._Row_4: Grd._Row_4: No._Row_5: No._Row_4: Course Title_Row_4: Hrs._Row_4: Cts._Row_4: Grd._Row_4: Course Title_Row_5: Hrs._Row_5: Cts._Row_5: Grd._Row_5: No._Row_6: Course Title_Row_6: Hrs._Row_6: No._Row_5: Course Title_Row_5: Hrs._Row_5: Cts._Row_5: Grd._Row_5: Cts._Row_6: Grd._Row_6: No._Row_7: Course Title_Row_7: Hrs._Row_7: Cts._Row_7: Grd._Row_7: Grd._0: No._Row_6: Course Title_Row_6: Hrs._Row_6: Cts._Row_6: Grd._Row_6: No._Row_7: Course Title_Row_7: Hrs._Row_7: Cts._Row_7: Grd._Row_7: Grd._0: No._Row_1: Course Title_Row_1: Hrs._Row_1: Cts._Row_1: Grd._Row_1: No._Row_2: Course Title_Row_2: Hrs._Row_2: Cts._Row_2: Grd._Row_2: No._Row_3: Course Title_Row_3: Hrs._Row_3: Cts._Row_3: Grd._Row_3: TypeofDegree: degree, during (YYMM: 11. DATE: (MM/DD/YYYY): 13. DATE: (MM/DD/YYYY): Term_g: Year_g: Year_h: Year_i: Year_j: Year_k: Year_l: Year_m: Year_n: Year_0: Term_h: Term_i: Term_j: Term_k: Term_l: Term_m: Term_n: Term_o: Hrs._Row_7: Cts._Row_7: Cts._Row_7: Hrs._Row_7: Hrs._Row_7: Cts._Row_7: Cts._Row_7: Hrs._Row_7: Cts._Row_7: Hrs._Row_7: Cts._Row_7: Hrs._Row_7: Cts._Row_7: Hrs._Row_7: Cts._Row_7: Hrs._Row_7: Cts._Row_7: CheckBox1: 0CheckBox2: 0CADET SIGNATURE: CADET SIGNATURE: Hrs._Row_7: Date) (MM/DD/YYYY: Date) (MM/DD/YYYY: CADET SIGNATURE: PROFESSOR OF MILITARY SCIENCE SIGNATURE: UniversityName: CadetName: