Plaintiffs claim and notice to defendant small claims court. Nebraska state court form required plaintiffs claim and. If you are an enlisted soldier, you can access the latest 174 r through the green to gold portal. Adobe acrobat reader is the free, trusted leader for reliably viewing, annotating, and signing pdfs. This pamphlet provides processes and procedures for all of the army. The documents provided below for download are in a variety of formats. If you use another pdf reader, it will not save or it might not open. Principal purpose form is used to make application for a green to gold 4, 3, or 2year scholarship. For use of this form, see usacc reg 1451, the proponent. How to prepare a planned academic worksheet cc form 104r the cc fm 104r is completed for each prospect you are working into the program to ensure academic alignment.
Cadet enrollment record cc form 9r green to gold rotc scholarship application cc form 173r. Cc form 104 r, dec 04 page 3 of 3 full name, last, first, mi name of university or college statement of understanding professor of military science signature type of degree cadet signature planned academic program worksheet for use of this form, see cc pam 1454, the proponent agency is atccpac 0 0 0. Data required by the privacy act of 1974 10 usc 2102 and 2107. Have cc form 104 r planned academic program worksheet which indicates 2 or 3 years remaining 4 semesters6 quarters for 2year applicants or 6 semesters9 quarters for 3year applicants as a fulltime student to degree completion summer sessions are authorized but cannot interfere with advance camp attendance. Cc form 7 r, aug 02 to authorizedecline the release of any and all official records maintained by the rotc department to personnel in the department of defense and. Green to gold rotc active duty option program application cc form 174 r. Army rotc scholarship acceptancedeclination statement and pms validation for use of this form, see cc reg. Army rotc green to gold application status notification. Routine uses form is used to obtain selection and eligibility information on applicants for a 2year green to gold active duty option program. Forms basic course initial enrollment forms these forms are to be filled out by applicants that are seeking to contract andor seek a scholarship. If youre reading this and still need the file, simply pm me for a copy.
Scholarship form cc form 173 r applicant snapshot form cc form 103 r medical examination forms dd form 2351. This gives the government access to your student records. If you are injured during rotc training and require medical treatment you must within 10 days see your rotc admin office. How to open pdf file on laptop or computer in hindi. Form is used to obtain selection and eligibility information on applicants for a 2year green to gold active duty option program. Cc form 2r statement of understanding cc form 174r green to gold active duty option program application cc form 228r financial statement da form 705 army physical fitness test. Part vi applicant statement rank last name first name ssn 4.
No one may file more than two complaints in a calendar week or more than ten complaints in a calendar year. If date specified is a reenlistment date, indicate period of original enlistment enter as yymmdd 2mile run 1 u. The plaintiff fills out the claim form and signs it in the presence of a court clerk or notary. Active dutyreserve rotc applicant snapshot for use of this form see, cc reg 1451, proponent agency is atccopis appendix b authority 10 usc 2102 and 2107 principal purpose to physically identify. Below is a list of the most current united states army cadet command forms. Pdf, 174r us army rotc green to gold active duty option program. Timeinserivce da form 4187 statement of understanding cc form 2 r.
Authorization for access to student records cc form 7 r. Form is used to make application for the green to gold 4, 3, or 2year scholarship. It is recommended that you have the latest version of adobe acrobat reader 4. Army physical fitness test apft scorecard da form 705. I certify that the waiver of rights documentation has been completed iaw cc pam 1454. When printing the name of your parents put their first and last name example.
It is a requirement for any cadet that enrolls in the program to complete within their first semester. Briefing on government sponsored benefits for rotc cadets rotc cadet cmd pam 1454 i have been briefed this date on governmentsponsored benefits for rotc cadets and understand that. If you do not have a physician that is familiar with. Section 10194 of the omaha municipal code and the rules and regulations based thereon require. Scholarship form cc form 173r applicant snapshot form cc form 103r medical examination forms dd form 2351. Routine uses form is used to obtain selection and eligibility information on applicants for 4, 3, or 2year scholarships. Data required by the privacy act of 1974 authority 10 usc 2102 and 2107. For use of this form, see cc reg 1451, the proponent agency is atccois.
The intent of this form is to input the data on the pc to prevent errors, especially in the formulas. Cadet command form 104r planned academic program worksheet must be fully typed, signed by academic advisor, signed by the cadet and turnedin to your primary military science instructor. Principal purpose form is used to make application for a green to gold active duty option. Statement as to the applicants performance on active duty and potential to be eligible and qualified to receive a regular army commission, if offered. How to prepare a planned academic worksheet cc form. Download, go to downloaded files, rightclick file, select open with adobe pdf. Cc form 2 r statement of understanding cc form 174 r green to gold active duty option program application cc form 228 r financial statement da form 705 army physical fitness test scorecard sergeant and above must submit copies of the last two da form 21668 nco evaluation report and latest da form 1059 service school academic. Aug for the fall term and 16 aug15 dec for the springwinter. Nebraska state court form required plaintiffs claim. Cc form 174 r, nov 08 a2 page 2 of 2 statement as to the applicants military aptitude and motivation. Cc form 7r, aug 02 to authorizedecline the release of any and all official records. Questions about the ccform4, or general information or assistance on completing or filing a ccform4, may be directed to the workers compensation commission counselor division, 405 5228760 or instate toll free 800 5228210. Cc form 174 r green to gold active duty option application 41. Da form 80 record of individual performance of reserve duty training.
Forms, regs, documents unc charlotte army rotc unc. As a current student on this bumpy collegiate pathway, i stumbled upon course hero, where i can find study resources for nearly all my courses, get online help from tutors 247, and even share my old projects, papers, and lecture notes with other students. Cc form 6 r briefing on government sponsored benefits for rotc cadets. Da form 3425 r medical fitness statement this can be signed by a family physician familiar with your medical history. Downloadfileasync is the best way to download file. Financial statement cc form 228r army green to gold. Application cc form 174 r green to gold active duty option cc form 173 r scholarship signed and dated by individual verified by milpo signed and dated by commanding officer and field grade commander applicant snapshot cc form 103 r deployed soldiers may send polaroid with copies of deployment orders. The cc form 9r is not a contract that obligates the cadet to a career in the army.
Statement as to the applicants performance on active duty and potential to be eligible and qualified to. When advised to do sodownload, complete please type as much as possible, and submit enrollment forms in person to the rotc offices. They are to be submitted in person, at our offices. Ccf174 r pg 1 for use of this form, see cc reg 1451, the proponent agency is atccopis data required by the privacty act of 1974. Cadet enrollment record cc form 9 r green to gold rotc scholarship application cc form 173 r.
No one may file more than two complaints in a calendar week or more than ten complaints in. The green to gold scholarship program is a program that provides eligible, regular. Send original to workers ompensation ommission and 1 copy to insurance arrier. If additional space is required, attach another sheet. Cc form 228r nco evaluation report da form 21668 test phone. You are covered medically under federal workers compensation for injury while traveling to and from, and during rotc training as long as you are registered as a fulltime student and properly enrolled in rotc. For use of this form, see cc pam 1454, the proponent agency is atccpc 20 usc 1232g, and public law 93380. Army rotc green to gold program application for use of this form, see usacc reg 1451, the proponent agency is atccroi. Cc form 174r green to gold active duty option application 41.
Routine uses form is used to obtain selection and eligibility information on. Copies of the documentation andor supporting documents as indicated above have been provided to the cadet and the cadet has been afforded an opportunity to comment. Age 46 civil conviction 52 standardized test scores 56 cgpa 58. Army rotc scholarship acceptancedeclination statement and pms validation for use of this form, see cc reg 1451, the proponent agency is atccopis data required by the privacy act of 1974 authority 10 usc 2101 and 2107. For use of this form see, cc reg 1451, proponent agency is. Make sure to click slow download remember, to use the latest adobe reader. Cc form 104r, dec 04 page 2 of 3 planned academic program worksheet for use of this form, see cc pam 1454, the proponent agency is atccpac. All contracting cadets need to read this thoroughly. As a current student on this bumpy collegiate pathway, i stumbled upon course hero, where i can find study resources for nearly all my courses, get online help from tutors 247, and even share my old. In part i where indicated print your first name, middle initial, and last name. It is the proper registration information that is required for continued. Application cc form 174r green to gold active duty optioncc form 173r scholarship signed and dated by. Cc form 104 r is a cadets academic plan to graduate. Appendix b active dutyreserve rotc applicant snapshot.
Stack overflow for teams is a private, secure spot for you and your coworkers to find and share information. You are covered medically under federal workers compensation for injury while traveling to and from, and during rotc training as long as you are registered as a fulltime student and properly enrolled in. Cc fm 174r contained in appendix b containing a favorable. How to prepare a planned academic worksheet cc form 104r. State briefly why you want to become an army officer. If applicants have a change of address, want to withdraw. Applicable to injuries deaths occurring on or after 2114. The plaintiff decides how the notice will be served and is responsible for service.
Cc form 174r, nov 08 a2 page 2 of 2 statement as to the applicants military aptitude and motivation. Disclosure information provided on this form is mandatory, without the data provided on this form, the application cannot be considered for participation into this program. If not already listed, print the name of the school you are attending. Army rotc green to gold active duty option program application for use of this form, see cc reg 1451, the proponent agency is atccopis data required by the privacty act of 1974. Cc form 104r, academic planning record osu army rotc. For use of this form see, cc reg 1451, proponent agency is atccoi. Ccf174r pg 1 for use of this form, see cc reg 1451, the proponent agency is atccopis data required by the privacty act of 1974. Active duty application cc form 174r army green to gold.
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