DD 3067-15 Science, Mathematics, and Research for Transformation (S

OMB NO. 0704-0466
OMB approval expires
YYYYMMDD

Science, Mathematics, and Research for Transformation (SMART) Scholarship
Revised Degree Completion Plan
PRIVACY ACT STATEMENT

AUTHORITY: 10 U.S.C. 4093, Science, Mathematics, and Research for Transformation (SMART) Defense Education Program; 10 U.S.C. 133a, Under
Secretary of Defense for Research and Engineering; DoD Directive 5137.02, Under Secretary of Defense for Research and Engineering (USD(R&E)); DoD
Instruction 1025.09, Science, Mathematics, and Research for Transformation Defense Education Program.
PURPOSE: To record revisions to a SMART Scholar’s degree completion plan.
ROUTINE USES: While the information requested on this form is primarily intended to be used internally, in certain circumstances it may be necessary to
disclose this information externally, pursuant to 5 U.S.C. 552a(b)(3), including: to contractors, grantees, experts, consultants, students, and others performing or
working on a contract, service, grant, cooperative agreement, or other assignment for the Federal Government when necessary to accomplish an agency
function, or, to academic institutions for the purposes of providing progress reports for applicants and participants. A complete list of routine uses may be found in
the applicable Privacy Act System of Records Notice, DUSDA 14, Science, Mathematics, and Research for Transformation (SMART) Information management
System, found at https://dpcld.defense.gov/Portals/49/Documents/Privacy/SORNs/OSDJS/DUSDA-14.pdf?ver=KO2ZkLWhxB3QCZoRTElMFA%3d%3d
DISCLOSURE: Voluntary; however, failure to provide the requested information may result in SMART scholar being non-compliant with SMART policy, and
subject to possible dismissal.
The public reporting burden for this collection of information is estimated to average one hour per response, including the time for reviewing instructions,
searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments
regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing the burden, to the Department of Defense,
Washington Headquarters Services, at whs.mc-alex.esd.mbx.dd-dod-informationcollections@mail.mil. Respondents should be aware that notwithstanding any
other provisions of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB
control number.
INSTRUCTION: SMART scholars submit a Revised Degree completion Plan to accompany a SMART Service Agreement Amendment Request in order to
provide a more detailed timeline for degree completion. Complete each section below per the instructions, as applicable.

SECTION 1 – Recruitment Awardee Information
Instructions: Graduate and Undergraduate level scholars requesting an Award Length Change (ALC) or Leave of Absence (LOA) complete the section below.
Requirement

Date (YYYYMMDD)

Notes

Revised Degree Completion Date: *

NEEDS DD67

Revised Degree Conferral Date: **

Notes: * Degree Completion Date – date on which an individual completes all degree requirements. This generally occurs prior to degree conferral and is not set
forth on official transcripts.
** Degree Conferral Date – date on which a degree is bestowed upon an individual. This is set forth on the official transcript reflecting the degree earned
and may occur after degree completion.

SECTION 2 – Graduate Degree Requirements
Instructions: Graduate level scholars complete the section below. In reverse chronological order, reflect all requirements that are to be met prior to degree
completion including, but not limited to: thesis/dissertation editing, defense date, defense application date, committee appointments, proposal submittals,
publishing requirements, and candidacy/qualifying exams.
Requirements Prior to Degree Completion
Requirement

Date (YYYYMMDD)

Notes

SECTION 3 – Coursework Summary
Instructions: Graduate and undergraduate scholars seeking an award length increase, academic institution change, or a Leave of Absence complete the section
below. Full time enrollment is required for each term.
For award length increases, state the number of additional terms required for degree completion:
Number of credits required for degree completion:

Academic Calendar System:

Semester

DD FORM 3067-15, 20220701 DRAFT

Number of credits remaining for degree completion:

Quarter

Year-Round
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Term
(Spring/Summer/Fall/Winter)

Start Date
(YYYYMMDD)

End Date
(YYYYMMDD)

Credits
Required

Enrollment Only? *

Yes

No

Yes

No

Yes

No

Yes

No

Yes

No

Yes

No

Yes

No

Yes

No

Yes

No

Yes

No

Yes

No

Yes

No

Yes

No

Course Title

NEEDS DD67

DD FORM 3067-15, 20220701 DRAFT

Yes

No

Yes

No

Yes

No

Yes

No

Yes

No

Yes

No

Yes

No

Yes

No

Yes

No

Yes

No

Yes

No

Yes

No

Yes

No

Yes

No

Yes

No

Yes

No

Yes

No

Yes

No
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Term
(Spring/Summer/Fall/Winter)

Start Date
(YYYYMMDD)

End Date
(YYYYMMDD)

Credits
Required

Enrollment Only? *

Yes

No

Yes

No

Yes

No

Yes

No

Yes

No

Yes

No

Yes

No

Yes

No

Yes

No

Yes

No

Yes

No

Yes

No

Yes

No

Course Title

NEEDS DD67
Yes

No

Yes

No

Yes

No

Yes

No

Yes

No

Yes

No

Yes

No

Yes

No

Yes

No

Yes

No

Yes

No

Yes

No

Yes

No

Yes

No

Yes

No

* For PhD students, indicate if you are requesting to maintain enrollment with no associated tuition cost for the remainder of your degree program.
Scholar Signature:

Advisor Signature:

Date (YYYYMMDD):

Date (YYYYMMDD):

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