Form 131-R - Cadet Action Request
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1
2CADET ACTION REQUEST
(ROTC Cadet Command Pam 145-4)
Data required by the Privacy Act of 1974
Authority: 10 USC 2102 and 2107. Principal Use(s): For use by cadet or battalion commander/PMS in initiating a request for personnel
action.
Routine Use(s): To initiate cadet actions for waivers, exception, or change in scholarship status by the Cadet or battalion commander/PMS.
Disclosure: Voluntary. However, failure to provide necessary action will preclude consideration of the request.
1. FROM
2. THRU
)
3. TO
)
(Include ZIP Code)
(Include ZIP Code
(Include ZIP Code
4. POC FOR THIS ACTION
):
(Name and Telephone
SECTION I - PERSONAL DATA
5. NAME (
6. SSN
7. MAILING ADDRESS
Last, First, MI)
(Home of record)
8. SMP UNIT ADDRESS (
:
If applicable)
SECTION II – REQUEST FOR PERSONNEL ACTION
9. I request the following action: (Check the appropriate)
Administrative Suspension
* Leave of Absence
Age Waiver
Medical Determination
Alien Participation
Medical Waiver
Camp Deferment
* Probation
Change of Major
RE Code Waiver
Civil Conviction Waiver
Transfer
Dependency Waiver
Scholarship Termination
Disenrollment
Other (Specify) _________________
Waiver of Rights
Board of Officers
* (Effective date: ________________)
SECTION III – (
)
Applies to Section II for all actions excluding Waiver of Rights
10. Reason for the Request/Remarks: (Continue on blank sheet)
11. CADET’S SIGNATURE
12. DATE
ROTC Cadet Command Form 131-R, Nov 99
Previous edition obsolete
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