AFROTC DETACHMENT 165
ACADEMIC PLAN
I. ADMINISTRATIVE DATA
II. INITIAL REVIEW
1. NAME (Last, First, MI)
1. INSTITUTION OFFICIALS SIGNATURE & DATE
I certify that if the stated individual completes all coursework as outlined in this form,
he/she will graduate during the date in Block I.5 in the academic major in Block I.4.
2. AFROTC DETACHMENT
2. AFROTC REVIEWER’S SIGNATURE & DATE
3. ACADEMIC INSTITUTION
4. ACADEMIC MAJOR
3. STUDENT’S SIGNATURE & DATE
5. COMPLETION OF THIS EDUCATION PLAN WILL RESULT IN MY OBTAINING A
BACHELOR OF _________ DEGREE IN THE ABOVE ACADEMIC MAJOR DURING
_________
MONTH
4. STATEMENT OF UNDERSTANDING
I, the undersigned, hereby declare that I will not change my academic major nor my
graduation date without prior approval.
___________
___________
CALENDAR YR FISCAL YEAR
______________________________________________________________
SIGNATURE OF CADET & DATE
Graduation Date
.
III. CADRE ORGINIAL STAMP, SIGNATURE, AND DATE
IV. SIGNATURE REQUIRED AFTER GRADUATION
I certify that I have successfully completed all degree requirements and
will graduate as stated in Block I.
CHANGE #
______________________________________________________
SIGNATURE OF CADET & DATE
NAME:
MAJOR:
TERM:
Course
Number
GRAD DATE:
YEAR:
TERM:
Credit
Hrs
Attempt
Course Title
Credit
Hrs
Comp
Course
Number
YEAR:
Credit
Hrs
Attempt
Course Title
Credit
Hrs
Comp
REMARKS
REMARKS
TERM REEVALUATION - I certify that the listed student is currently enrolled in the above courses and that
he/she is still on track to graduate during the listed date with a degree in the listed academic major.
TERM REEVALUATION - I certify that the listed student is currently enrolled in the above courses and that
he/she is still on track to graduate during the listed date with a degree in the listed academic major.
INSTITUTION OFFICIALS SIGNATURE & DATE
AFROTC REVIEWER’S SIGNATURE & DATE
STUDENT’S SIGNATURE & DATE
TERM:
Course
Number
YEAR:
Course Title
INSTITUTION OFFICIALS SIGNATURE & DATE
TERM:
Credit
Hrs
Attempt
Credit
Hrs
Comp
AFROTC REVIEWER’S SIGNATURE & DATE
STUDENT’S SIGNATURE & DATE
Course
Number
YEAR:
Course Title
Credit
Hrs
Attempt
Credit
Hrs
Comp
REMARKS
REMARKS
TERM REEVALUATION - I certify that the listed student is currently enrolled in the above courses and that
he/she is still on track to graduate during the listed date with a degree in the listed academic major.
TERM REEVALUATION - I certify that the listed student is currently enrolled in the above courses and that
he/she is still on track to graduate during the listed date with a degree in the listed academic major.
INSTITUTION OFFICIALS SIGNATURE & DATE
STUDENT’S SIGNATURE & DATE
AFROTC REVIEWER’S SIGNATURE & DATE
INSTITUTION OFFICIALS SIGNATURE & DATE
STUDENT’S SIGNATURE & DATE
AFROTC REVIEWER’S SIGNATURE & DATE
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NAME:
MAJOR:
TERM:
Course
Number
GRAD DATE:
YEAR:
TERM:
Credit
Hrs
Attempt
Course Title
Credit
Hrs
Comp
Course
Number
YEAR:
Credit
Hrs
Attempt
Course Title
Credit
Hrs
Comp
REMARKS
REMARKS
TERM REEVALUATION - I certify that the listed student is currently enrolled in the above courses and that
he/she is still on track to graduate during the listed date with a degree in the listed academic major.
TERM REEVALUATION - I certify that the listed student is currently enrolled in the above courses and that
he/she is still on track to graduate during the listed date with a degree in the listed academic major.
INSTITUTION OFFICIALS SIGNATURE & DATE
AFROTC REVIEWER’S SIGNATURE & DATE
STUDENT’S SIGNATURE & DATE
TERM:
Course
Number
YEAR:
Course Title
INSTITUTION OFFICIALS SIGNATURE & DATE
TERM:
Credit
Hrs
Attempt
Credit
Hrs
Comp
AFROTC REVIEWER’S SIGNATURE & DATE
STUDENT’S SIGNATURE & DATE
Course
Number
YEAR:
Course Title
Credit
Hrs
Attempt
Credit
Hrs
Comp
REMARKS
REMARKS
TERM REEVALUATION - I certify that the listed student is currently enrolled in the above courses and that
he/she is still on track to graduate during the listed date with a degree in the listed academic major.
TERM REEVALUATION - I certify that the listed student is currently enrolled in the above courses and that
he/she is still on track to graduate during the listed date with a degree in the listed academic major.
INSTITUTION OFFICIALS SIGNATURE & DATE
STUDENT’S SIGNATURE & DATE
AFROTC REVIEWER’S SIGNATURE & DATE
INSTITUTION OFFICIALS SIGNATURE & DATE
STUDENT’S SIGNATURE & DATE
AFROTC REVIEWER’S SIGNATURE & DATE
PAGE ___ OF ___ PAGES