Da Form 2125 Report To Training Agency
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2REPORT TO TRAINING AGENCY
For use of this form, see AR 621-1; the proponent agency is DCS, G-1.
DATA REQUIRED BY THE PRIVACY ACT OF 1974
Section 301, Title 5, USC; and Section 3013, Title 10.
AUTHORITY:
To provide a continuing contact with the military student while in attendance at a civilian school
PRINCIPAL PURPOSE:
under a military sponsored program.
Data collected is used to identify the school; to monitor the subject studies; to obtain student
ROUTINE USES:
response to selected question; to identify the Army program; to obtain course title /s/, credit hours
and grades; to obtain academic plan including faculty advisor awareness; and to establish an
address including home phone whereby the military student can be contacted since, normally, the
student will reside off-post.
Disclosure of information is mandatory. If required information is not provided removal from the
DISCLOSURE:
school could result or military student could be subject to a violation of Article 92 UCMJ.
Last Name - First Name - Middle Initial
Grade
Social Security No.
Branch/MOS
Current Mailing Address (Include ZIP Code)
Home Phone (Include Area
Army Program (Check one)
Code)
Scholarship
Fully Funded
Degree
Cooperative
Completion
Degree
Name of School (City & State)
Electronic Mail Address
Type System (Check one)
Semester
Quarter
Other
Department and Major Field of Study
Official Title of Degree Which You Expect to
Date
Receive
Expected
QUARTER, SEMESTER OR TERM JUST COMPLETED
QUARTER, SEMESTER OR TERM UPCOMING
Began
Ended
Begins
Will End
SUBJECTS STUDIED DURING ABOVE PERIOD
SUBJECTS TO BE STUDIED
Course
Credit
Course
Credit
Course Title
GRADE
Course Title
No.
Hours
No.
Hours
Give reason for any absence which may affect your ability to keep up with your studies (Sickness, leave, or other emergencies)
If you are having any difficulty with your academic work, give pertinent details
If any subjects have been dropped since last report, give reasons
If any subjects outside of normal prescribed course have been added since last report, give complete information (If added course will necessitate a
change in present contract, clearance must be obtained from the training agency.)
(Enter any recommendations, observations, or requests you desire to make)
Remarks
The reverse side of this form will be completed by the student and faculty advisor initially upon entry into school and when changes to
NOTE:
academic programs are required.
Date
Signature of Student
EDITION OF OCT 1984 IS OBSOLETE.
APD LC v1.02ES
DA FORM 2125, MAR 1999
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