PLANNED ACADEMIC PROGRAM WORKSHEET
1. NAME OF STUDENT (LAST, FIRST, MI) 2. ACADEMIC MAJOR 3. AS OF DATE (DAY,MONTH,YEAR)
philosophy
4 TERM, YEAR, COURSE NUMBER, COURSE TITLE,COURSE CREDIT HOURS, CREDITS THAT COUNT TOWARDS ACADEMIC DEGREE, AND ACHIEVED GRADES.
a b c
Term: fall 07 Term: winter 07=08 Term: spring 08
No. Course Title Hrs. No. Course Title Hrs. No. Course Title Hrs.
anth 101 cultural anthropology 5 cpla 100 computer literacy 1 1 hum 211 masterpieces of west world 5
engl 101 exposition and argument 5 cpla 101 computer literacy 2 1 math 115 mathmatical reasoning 5
govt 101 modern gov in amer contex 5 enlg 201 analysis/ res/doc 5 mlsc 103 military leadership and values 2
mlsc 101 military values and leadership 2 musc 212 music in humanities 5 phil 322 hist contemporary phil 5
phil 211 intro philosophy 5
mlsc 102 leadership and military values 2
Total Term Hours: 17 Total Term Hours: 19 Total Term Hours: 17
d e f
Term: fall 08 Term: winter 08-09 Term: spring 09
No. Course Title Hrs. No. Course Title Hrs. No. Course Title Hrs.
bio 100 intro biology 5 mlsc 202 military leadership and values 2 mlsc 203 military leadership and values 2
phil 320 hist ncint philosophy 5 phil 321 hist modern philosophy 5 phil class not listed 5
phil 411 theory of knowledge 5 phil class not listed 5 phil class not listed 5
mlsc 201 leadership and military values 2
Total Term Hours: 17 Total Term Hours: Total Term Hours:
g h i
Term: fall 09 Term: winter 09-10 Term: spring 10
No. Course Title Hrs. No. Course Title Hrs. No. Course Title Hrs.
mlsc 301 military values and leadership 2 mlsc 302 military values and leadership 2 military values and leadership 2
phil class not listed 5 phil class not listed 5 phil class not listed 5
phil class not listed 5 phil class not listed 5 phil class not listed 5
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 yes No (if no, list exceptions on reverse side of this form). Completion
should result in a bachelor degree, during (YYMM): 1106
s
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) Page 1 of 4 Pages
PLANNED 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)
4a TERM, YEAR, COURSE NUMBER, COURSE TITLE,COURSE CREDIT HOURS, CREDITS THAT COUNT TOWARDS ACADEMIC DEGREE, AND ACHIEVED GRADES.
j k l
Term: Year: Term: Year: Term: Year:
No. Course Title Hrs. No. Course Title Hrs. No. Course Title Hrs.
mlsc 401 military values and leadership 2 mlsc 402 military values and leadership 2 mlsc 403 military values and leadership 2
phil class not listed 5 phil class not listed 5 phil class not listed 5
phil class not listed 5 phil class not listed 5 phil class not listed 5
Total Term Hours: Total Term Hours: Total Term Hours:
m n o
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:
p q r
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:
ROTC CADET COMD FORM 104-R (Aug 98) Page 2 of 4 Pages
PLANNED ACADEMIC PROGRAM WORKSHEET
(ROTC Cadet Comd Pam 145-4)
DATA REQUIRED BY PRIVACY ACT STATEMENT OF 1974
1. AUTHORITY: Title 10, US Code 2101 and 2104
2. PRINCIPAL PURPOSE(S): To provide information and data necessary for administering the Army Senior ROTC program and processing and managing of selected students for commissioning
in the Army IAW established public law and Army Regulations.
3. ROUTINE USES: To provide a projected academic plan to determine if the applicant meets the public law requirements of two remaining academic years.
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.
1. NAME OF STUDENT (LAST, FIRST, MI) 2. ACADEMIC MAJOR 3. AS OF DATE (DAY,MONTH,YEAR)
philosophy
8. INSTITUTION OF ATTENDANCE AND IDENTIFICATION 9. CREDIT HOURS 10. GRADE POINT AVERAGE (GPA)
a. Name: eastern washington university a. Total required for degree: 180
b. Identification (Check one): Host (1) Total ROTC Hours: 24 a. Cumulative 3.37
Extension Center (2) ROTC Hours that count: 24 b. Last Term 3.24
Cross-Enrolled (3) Total Hours Rqd w/ROTC: 12 c. Grading Scale
c. If attendance is at an extension center or cross-enrolled school, b. Transfer Credits accepted 0
name of the host institution: c. Credits toward deg Comp to date: 55
d. ROTC Comp to Date (don't count towd deg): 6 h. Total Programmed hours (w/ROTC): 24
e. Remaining for Degree: 125
f. Remaining Terms: 9
g. "Adequate" Progression: e divided by f 14
We, the undersigned, hereby declare that the program outlined on the worksheet (on the reverse side of this statement) that
Cadet: is about to undertake is a formally structured program approved by
(Cadet Name) (Name of University or College)
designed to meet the requirements of a ; that the degree to be attained is the culmination of an
(TYPE OF DEGREE)
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.
(Date) (CADET SIGNATURE)
(Date) (PROFESSOR OF MILITARY SCIENCE SIGNATURE)
ROTC CADET COMD FORM 104-R (Aug 98) Page 3 of 4 Pages
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ROTC CADET COMD FORM 104-R (Aug 98) Page 4 of 4 Pages