Form 104-R - Planned Academic Program Worksheet
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1
2
3PLANNED ACADEMIC PROGRAM WORKSHEET
(ROTC Cadet Comd Pam 145-4)
1. NAME OF STUDENT (LAST, FIRST, MI)
2. ACADEMIC MAJOR
3. AS OF DATE (DAY,MONTH,YEAR)
4
TERM, YEAR, COURSE NUMBER, COURSE TITLE,COURSE CREDIT HOURS, CREDITS THAT COUNT TOWARDS ACADEMIC DEGREE, AND ACHIEVED GRADES.
a
b
c
Term:
Year:
Term:
Year:
Term:
Year:
No.
Course Title
Hrs.
No.
Course Title
Hrs.
No.
Course Title
Hrs.
Total Term Hours:
Total Term Hours:
Total Term Hours:
d
e
f
Term:
Year:
Term:
Year:
Term:
Year:
No.
Course Title
Hrs.
No.
Course Title
Hrs.
No.
Course Title
Hrs.
Total Term Hours:
Total Term Hours:
Total Term Hours:
g
h
i
Term:
Year:
Term:
Year:
Term:
Year:
No.
Course Title
Hrs.
No.
Course Title
Hrs.
No.
Course Title
Hrs.
Total Term Hours:
Total Term Hours:
Total Term Hours:
7. REVIEW: All of the above courses are required (as a minimum) for the completion of the degree:
Yes
No
(if no, list exceptions on reverse side of this form). Completion
should result in a
degree, during (YYMM):
5. SIGNATURE OF STUDENT:
5a. DATE:
6. SIGNATURE OF REGISTRAR AND EXAMINER OF CREDENTIALS (OR OTHER INSTITUTION CERTIFYING OFFICIAL).
6a. DATE:
ROTC CADET COMD FORM 104-R (Aug 98)
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