1. NAME OF STUDENT (LAST, FIRST, MI)
3. AS OF DATE (MM/DD/YYYY)
a. IDENTIFICATION (Check one):
(Have the student initial and date beside each
term to indicate they have been counseled)
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
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
TERM, YEAR, COURSE NUMBER, COURSE TITLE, COURSE CREDIT HOURS, CREDITS THAT COUNT TOWARDS ACADEMIC DEGREE, AND ACHIEVED GRADES.
Title 10, US Code 2101 and 2104
established public law and Army Regulations.
: To provide a projected academic plan to determine if the applicant meets the public law requirements of two remaining academic years.
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.
8. STUDENT INITIALS & DATE:
(1) ROTC Hours that do not count:
(Date of form preparation)
6. GRADE POINT AVERAGE (GPA)
b. Credits toward degree Comp to date:
Normal Academic Progression Standard
c. Transfer Credits accepted:
(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