USACC Form 104-R at a glance
What it is: Principal Purpose of the Planned Academic Program Worksheet, USACC Form 104-R: to provide a projected academic plan to determine if the applicant meets the public law requirements of two remaining academic years.
Who signs: Signature of Cadet, and signature of Registrar or ROTC advisor and other institution certifying official; Cadet should sign and date; PMS should sign and date.
A filled-in USACC Form 104-R example: a transfer cadet plans four semesters
How to fill out USACC Form 104-R, box by box
1. Name of student and Cadet ID, 2. Academic major, 2a. CIP code and 3. As of date
Enter the Cadet's name and Cadet ID.
Enter the Cadet's Academic Major.
2a CIP CODE is only used for HQ STEM Scholarships and is not necessary for all other scholarships.
Enter the date of form preparation or date of form update.
4. Type of degree currently pursuing
Select the type of degree the Cadet is pursuing: Bachelors, Masters, or Associates (MJC Only).
5. Credit hours
Block 5 calculates how many scholarship terms the Cadet needs to graduate.
Select the appropriate term type and degree plan from the dropdown; making the correct selection is required for Block 5 to calculate correctly.
Input the total hours required for the degree (a). Input ROTC hours that are not included in the total for the degree (1).
5a(2) populates the sum of 5a and 5a(1). 5a(3) calculates the average number of hours required for each term based on the selection in the dropdown and the sum from 5a(2).
Input the number of credit hours the Cadet has completed (if any) to date at the school (b).
Input any transfer credits the school has accepted (c).
Calculates how many hours the Cadet has remaining for their degree (d).
5e calculates the number of scholarship terms the Cadet needs to complete their degree based on calculations from 5a(3) and 5d.
6. Grade point average (GPA)
Input the term GPA and the cumulative GPA for each term completed.
7. Bde, host school and academic school
Select the Cadet's Brigade, ROTC Program (Host School), and Academic School.
8. Academic school identification (Check one)
Select Academic School's identification: If the academic school is the same as the Host School, select Host; if the academic school is not the Host School, select either Extension Unit or Cross-Town.
Host: Academic School is the Same as Host School. Extension Unit: Academic School is a manned partner school. Cross-Town: Academic School is an unmanned partner school.
The Cadet must take ROTC classes at Host school or nearest manned Extension Unit.
9. Term, year, course number, course title, course credit hours, achieved grades and distance learning (DL)
Each group represents one term.
Select the term from the dropdown: Fall, Winter (for quarter schools), Spring, or Summer; select the year for the term selected; input the Course Number, Course Title, course Credit Hours, and check the column for DL? if the class is online.
Once the term is finished, input the grade received.
10. Student initials and date
The student should initial and date beside each term they have completed to indicate they have been counseled.
11. Term, year, course number, course title, course credit hours, achieved grades and distance learning (DL) (continued)
Follow the instructions for Box 9: Term, Year, Course Title and Total Term Hours.
12. Review
Verify that the courses listed in Box 9 and Box 11 are required for the degree.
Review: All of the courses are required (as minimum) for the completion of the degree: Yes, or No (if no, list exceptions on reverse of this form).
Input the expected graduation date: the Completion Date (Month, Year), with the (Degree Type) and the (Academic Discipline) the completion should result in.
13. Signature of student, 14. Date, 15. Signature of registrar and examiner of credentials or ROTC advisor and 16. Date
Signature of Cadet, and the date Cadet signed document (MM/DD/YYYY).
Signature of Registrar or ROTC advisor and other institution certifying official, and the date certifying official signed document (MM/DD/YYYY).
Statement of understanding
The Cadet should read the Statement of Understanding and then sign and date; the PMS should sign and date.
Enter the Cadet's FULL NAME (Last, First, MI), the Name of University or College and the Type of Degree.
If the Cadet is an ROTC Scholarship participant, the scholarship will be in force for the number of semesters indicated in Block 5.
The worksheet must be authenticated by an appropriate school academic official (academic advisor/counselor) when completed or revised.
IAW USACC Pam 145-4, the worksheet must be reviewed annually (at a minimum) for each contracted Cadet and revised, as necessary.
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.
The PMS will review the worksheet with the Cadet each school term to monitor alignment/mission set and academic progress. This review will be noted on Cadet counseling records.
Any changes to this degree plan, adding/dropping classes, or change of major must first be discussed/approved with the PMS.
More rules for USACC Form 104-R
The public reporting burden for this collection of information is estimated to average 25 minutes per response.
Voluntary information is necessary to determine eligibility of the individual for acceptance, continuance, or discontinuance in the Army ROTC program.
USACC Form 104-R, JUNE 2026: previous editions are obsolete.
Common questions about USACC Form 104-R
What is a 104r form?
Principal Purpose of the Planned Academic Program Worksheet, USACC Form 104-R: to provide a projected academic plan to determine if the applicant meets the public law requirements of two remaining academic years. For use of this form, see USACC Pam 145-4, the proponent agency is ATCC-PAS.
Where do I file it?
Return the completed form to the requesting ROTC program.
Sources
[1] USACC Form 104-R (JUNE 2026), Planned Academic Program Worksheet, U.S. Army Cadet Command (the Official source link on this page).
