USACC Form 167-R at a glance
What it is: USACC Form 167-R, the U.S. Army ROTC Scholarship Acceptance/Declination Statement and PMS Validation, notifies ROTC Cadet Command that the winner accepts or declines a scholarship offer.
Who signs: Sign in box 9, CADET'S SIGNATURE, and enter the 10. DATE.
The winner notifies ROTC Cadet Command that winner accepts or declines a scholarship offer.
A filled-in USACC Form 167-R example: a cadet accepts a scholarship
How to fill out USACC Form 167-R, box by box
3. Name of winner, 4a. SSN and b. Cadet ID/Applicant ID
Enter the winner's name as Last Name, First Name, MI in box 3, the SSN (Last 4 digits) in box 4a and the Cadet ID/Applicant ID in box 4b.
5a. Scholarship control number and b. GRFD control number
Enter the SCHOLARSHIP CONTROL NUMBER in box 5a: a Scholarship offered without a Scholarship Control Number is unauthorized and not valid.
Enter the b. GRFD CONTROL NUMBER (if applicable).
6. Scholarship type
In box 6, SCHOLARSHIP TYPE, mark the type: Basic Camp, Graduate, Language, URBAN, STEM, Nurse, 2-Year Campus Based, 2-Year Advanced Designee (AD), 3-Year (or 2.5-Year) Campus Based, 3-Year Advance Designee (AD), 4-Year (or 3.5-Year) Campus Based, 2-Year GRFD-ARNG/USAR, 2-Year Ike Skelton Scholarship, 2-Year Dedicated ARNG/USAR, 3-Year (or 2.5-Year) Dedicated ARNG/USAR, 2-Year Green to Gold, 3-Year Green to Gold, 4-Year Green to Gold, National 4-Year High School or 3-Year Advance Designee (AD).
7. Decision
In box 7, DECISION, mark ACCEPT or DECLINE.
Individuals who do not notify ROTC Cadet Command of acceptance will lose their scholarship.
8. Reason for declination
In box 8, REASON FOR DECLINATION, mark 1 - Commitment, 2 - Academic Major Restriction, 3 - Non-Military Scholarship, 4 - Other Military Scholarship, 5 - ROTC Too Time Consuming, 6 - No Longer Interested or 7 - Other (Please explain).
PMS validation of 3- and 2-year advance designees
The PMS completes the PMS VALIDATION OF 3- AND 2-YEAR ADVANCE DESIGNEES; the transcript must be included for validation, and validation must be completed by 1 July the summer before the Cadet is scheduled to contract IAW CC PAM 145-1, 2-2h(7).
The PMS enters 1. GPA, Academic Cumulative and 2. GPA, ROTC Cumulative: no more than 4.0 will be entered, and if other than a 4.0 scale, the PMS converts using the table in USACC Reg 145-1.
The PMS enters the 3. MAJOR SUBJECT and the ACADEMIC MAJOR CODE.
For 4. STATUS OF MEDICAL QUALIFICATION, the PMS marks Qualified or Has Changed (Physical submitted to DoDMERB).
For 5. PMS RECOMMENDATION, the PMS marks Recommended or Not Recommended.
The PMS enters the 6. PROJECTED GRADUATION DATE (MMYYYY) and the 7. SCHOLARSHIP AWARD DATE(YYYYMMDD).
The PMS enters 8. PMS REMARKS.
For PMS VALIDATION OF 3- AND 2-YEAR ADVANCE DESIGNEES, the PMS signs on the PMS SIGNATURE line and enters the DATE (YYMMDD).
9. Cadet's signature and 10. Date
Sign in box 9, CADET'S SIGNATURE, and enter the 10. DATE.
In accepting this scholarship you understand that you will obtain a degree in the academic major indicated on your application/contract or you may lose your scholarship if you change to another academic discipline without prior written consent of the Professor of Military Science.
Sources
[1] USACC Form 167-R (JANUARY 2026), U.S. Army ROTC Scholarship Acceptance/Declination Statement and PMS Validation, U.S. Army Cadet Command (the Official source link on this page).