PLANNED ACADEMIC PROGRAM WORKSHEET

For use of this form, see CC Pam 145-4, the proponent agency is ATCC-PA-C

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, processing, and managing of selected students for commissioning in the Army IAW established public law and Army Regulations. 3. ROUTINE USE(S): To provide a prjected 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 (MM/DD/YYYY) (Date of form preparation)

Smith, Matthew, J
4. INSTITUTION OF ATTENDANCE AND IDENTIFICATION a. Name: b. Identification (Check one):

Political Science (Law and Legal Studies)

5. CREDIT HOURS Select Semester or Quarter (S/Q) 6. GRADE POINT AVERAGE (GPA)

4/10/2010
Term: Fall 08 Curr GPA: 3.1 Curr GPA: 3.2 Curr GPA: 3.7 Term: CUM: 3.1 CUM: 3.1 CUM: 3.3 Term: Sping 09 Term: Fall 09 Term: Curr GPA: Term: Curr GPA: Term: Curr GPA: Term: CUM: Curr GPA: Term: CUM: Curr GPA: CUM: CUM: CUM: CUM: CUM:

THE CITADEL
Host Extension Center Cross-Enrolled

S
129 16 145 16.11

a. Total required for degree: (1) ROTC Hours that do not count: (2) Total Hours Rqd for NAPS:
Normal Academic Progression Standard

c. If attendance is at an extension center or cross-enrolled school, list the name of the Host Institution:

b. Transfer Credits accepted: c. Credits toward degree Comp to date: d. Reamining for Degree: e. Number of authorized S/Qs:

145 9

Curr GPA: Term: Curr GPA:

7.

TERM, YEAR, COURSE NUMBER, COURSE TITLE, COURSE CREDIT HOURS, CREDITS THAT COUNT TOWARDS ACADEMIC DEGREE, AND ACHIEVED GRADES.
Term: No. Band-101 Biol-101 Biol-111 Engl-101 Hist-103 Mlty-101 Ortn-101 a. Fall Course Title Regimental Band and Pipes General Biology I General Biology Lab I Composition & Lit I History Western Civ I Leadership & Personal Devel First Year Expirience Year: 08 Hrs. Cts. Grd. 0 3 1 3 3 1 1 12 0 9 4 9 6 4 4 36 Term: No. A B A B C A A Term: No. Band-102 Biol-102 Biol-112 Engl-102 Hist-104 Mlty-102 Rped-251 b. Spring Course Title Regimental Band and Pipes General Biology II General Biology Lab II Composition & Lit II History Western Civ II Foundations in Leadership Found/Fitness & Exercise Year: 09 Hrs. Cts. Grd. 0 3 1 3 3 1 2 13 0 12 4 9 9 4 8 46 Term: No. Psci-102 Span-201 A A A B B A A Term: No. Band-201 Chem-103 Chem-113 Crmj-201 Engl-201 Math-104 Mlty-201 c. Fall Course Title Regimental Band and Pipes Intro to Chemistry I Intro to Chem Lab I Introduct to Criminal Justice Major British Writers I Elementary Matematical Model Innovative Tactical Leadership Year: 09 Hrs. Cts. Grd. 0 3 1 3 3 3 1 14 0 12 4 12 9 12 4 53 A A A A B A A

Total Term Hours:

Term: No. d. Fall continued Course Title

Total Term Hours:

e. Spring continued Course Title

Total Term Hours:

f. Fall continued Course Title American Natl Government Intermediate Spanish I

Year: 08 Hrs. Cts. Grd. 2 3 8 9 A B

Year: 09 Hrs. Cts. Grd. 3 6 C

Year: 09 Hrs. Cts. Grd. 3 3 12 9 A B

Rped-250 Cont Health Foundations Span-101 Elementary Spanish I

Span-102 Elementary Spanish II

Total Term Hours:

8. STUDENT INITIALS & DATE: (Have the student initial and date beside each term to indicate they have been counseled)

17

Total Term Hours:

Total Term Hours:

TERM 7: TERM 8: TERM 9:

21

TERM 1: TERM 2: TERM 3:

TERM 4: TERM 5: TERM 6:

CC Form 104-R, DEC 04

Page 1 of 3

CADEMIC PROGRAM WORKSHEET

CC Pam 145-4, the proponent agency is ATCC-PA-C

BY PRIVACY ACT STATEMENT OF 1974

y Senior ROTC program, processing, and managing of selected students for commissioning in the Army IAW

ublic law requirements of two remaining academic years. Voluntary information is necessary to determine eligibility of the individual for acceptance,

4/10/2010

, CREDITS THAT COUNT TOWARDS ACADEMIC DEGREE, AND ACHIEVED GRADES.

Page 1 of 3

PLANNED ACADEMIC PROGRAM WORKSHEET

For use of this form, see CC Pam 145-4, the proponent agency is ATCC-PA-C 7. TERM, YEAR, COURSE NUMBER, COURSE TITLE, COURSE CREDIT HOURS, CREDITS THAT COUNT TOWARDS ACADEMIC DEGREE, AND ACHIEVED GRADES. (CONTINUED)
Term: No. Band-202 Chem-104 Chem-114 Engl-215 Math-105 Mlty-202 Psci-232 g. Spring Course Title Regimental Band and Pipes Intro to Chemistry II Intro to ChemistryLab II Masterpieces of American Lit Finite Mathematics Leadership in Changing Envir Comparative Politics Year: 10 Hrs. Cts. Grd. 3 3 1 3 3 1 3 Term: No. Span-202 Mlty-301 Psci-340 Psci-498 Hist-417 a Hist-417 b h. Fall (Abroad Argentina) Course Title Intermediate Soanish II Advanced ROTC Latine American Affairs Independent Study Special Topics Special Topics Year: 10 Hrs. Cts. Grd. 3 2 3 3 3 3 Term: No. Psci-101 Psci-231 Badm-201 Psci-392 Psci-361 Mlty-302 Psci i. Spring Course Title Intro Political Science International Politics Priciples of Macroeconomics Political Theory Law and Legal Process Advanced ROTC American Politics Elective Year: 11 Hrs. Cts. Grd. 3 3 3 3 3 2 3

Total Term Hours:

Term: No. j. Spring continued Course Title

17

0
Term: No.

Total Term Hours:

k.

17

0
Term: No.

Total Term Hours:

l.

20

Year: 10 Hrs. Cts. Grd. 0 3 0 P

Course Title

Year: Hrs. Cts. Grd.

Course Title

Year: Hrs. Cts. Grd.

Rped-130 Weight Training Soci-201 Intro to Sociology

Total Term Hours:

Term: No. Psci-462 Psci Crmj Psci-361 Psci Mlty-401 Rped m. Fall Course Title Constitutional Law American Politics Elective Criminal Justice elective Law and Legal Process elective ROTC Golf

0
Term: No. Psci-461 Mlty-402 Psci Psci Psci Psc

Total Term Hours:

n. Spring Course Title Constitutonal Law (Power) ROTC subfield elective elective American Politics electice elective

0
Term: No.

Total Term Hours:

o.

Year: 11 Hrs. Cts. Grd. 3 3 3 3 3 2 0

Year: 12 Hrs. Cts. Grd. 3 2 3 3 3 3

Course Title

Year: Hrs. Cts. Grd.

Total Term Hours:

17

Total Term Hours:

17

Total Term Hours:

9. REVIEW: All of the above courses are required (as minimum) for the completion of the degree: result in a BA in Political Science Legal Studies

Yes

X 1205

No (if no, list exceptions on reverside of this form). Completion should

degree, during (YYMM):

10. SIGNATURE OF STUDENT:

11. DATE: (MM/DD/YYYY)

April 10, 2010

12. SIGNATURE OF REGISTRAR AND EXAMINER OF CREDENTIALS (OR OTHER INSTITUTION CERTIFYING OFFICIAL): 13. DATE: (MM/DD/YYYY)

CC Form 104-R, DEC 04

Page 2 of 3

CADEMIC PROGRAM WORKSHEET

CC Pam 145-4, the proponent agency is ATCC-PA-C

S, CREDITS THAT COUNT TOWARDS ACADEMIC DEGREE, AND ACHIEVED GRADES. (CONTINUED)

Page 2 of 3

PLANNED ACADEMIC PROGRAM WORKSHEET

For use of this form, see CC Pam 145-4, the proponent agency is ATCC-PA-C

STATEMENT OF UNDERSTANDING
We, the undersigned, hereby declare that the program outlined on the worksheet (on the reverse side of this statement) that Cadet Smith, Matthew, J
(FULL NAME, Last, First, MI)

is about to under take a formally structured program approved by

THE CITADEL
(Name of University or College)

designed to meet the requirments of a

BA in Political Science Legal Studies

(Type of Degree)

degree; that the degree to be attained is the culmination of an

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. If the cadet is an ROTC Scholarship participant, the scholarship will be in force for the number of semesters indicated in Block 5.

(Date) (MM/DD/YYYY)

(CADET SIGNATURE)

(Date) (MM/DD/YYYY)

(PROFESSOR OF MILITARY SCIENCE SIGNATURE)

CC Form 104-R, DEC 04

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CADEMIC PROGRAM WORKSHEET

CC Pam 145-4, the proponent agency is ATCC-PA-C

ENT OF UNDERSTANDING

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