EVALUATION REPORT & COUNSELING RECORD
1. Name (Last, First MI Suffix)
2. Class Year
4. Occasion for Report
Fall
Winter
Spring
7a. PRT/PFT
Date
5. Date of Report
Other
7b. HT/WT
WS
NS
10a. Duties Assigned:
11. Honors/Awards:
8. Sail Qualification
NONE
A
B
3. PLT – SQD
6. Type of Report
Regular
9. Swim Qualification
NONE
1st
2nd
Special
3rd
Date:
10b. Major:
For Mid-Term Counseling Use. (When completing Evaluation, enter 12 and 13 from counseling record). Have student sign block 14 as well as block 28.
12. Date Completed
13. Signature of Counselor
14. Signature of Individual Counseled
PERFORMANCE TRAITS: 1.0 – Below standards/not progressing or UNSAT in any one standard; 2.0 – Does not meet all 3.0 standards;
3.0 – Meets all 3.0 standards; 4.0 – Exceeds most 3.0 standards; 5.0 – Meets overall criteria and most of the specific standards for 5.0.
Standards are not all inclusive.
PERFORMANCE
1.0*
2.0
3.0
4.0
5.0*
TRAITS
Below Standards
Progressing
Meets Standards
Above
Greatly Exceeds Standards
15.
- Displays personal bias or
- Always treats others with
- Admired for fairness and human
Equal
engages in harassment.
fairness and respect
respect.
Opportunity:
- Lacks respect for EO
- Does not condone bias or
- Ensures a climate of fairness and
Fairness, respect
objectives.
harassment in or outside the
respect for human worth.
for human
- Interferes with order and
Battalion.
- Leader and model contributor to
worth.
discipline by disregarding
- Positively contributes to Unit
Unit cohesiveness and morale.
(NOB)
rights of others.
morale and cohesiveness.
Midterm
Final
16.
- Creates conflict, unwilling
- Reinforces other’s efforts, meets
- Team builder: inspires
Organizational
to work with others, puts self
personal commitments to team.
cooperation and progress.
Support:
above team.
- Understands team goals,
- Talented mentor: focuses goals
contributions
- Fails to understand team
employs good teamwork
and techniques for team.
towards team
goals or teamwork
techniques.
- The best at accepting and offering
building and team
techniques.
- Accepts and offers team
team direction.
results.
- Does not take direction
direction.
- Volunteers for almost everything.
Communication
well.
- Will volunteer if asked to.
Skills.
- Finds excuses to get out of
(NOB)
Battalion activities.
Midterm
Final
17.
- Unsatisfactory demeanor or
- Excellent personal appearance.
- Exemplary personal appearance.
Military Bearing/
conduct.
- Excellent demeanor or conduct.
- Exemplary demeanor or conduct.
Appearance,
- Consistently
- Complies with physical
- Excellent or Outstanding PRT. A
Physical Fitness
unsatisfactorily appearance.
readiness program, within all
leader in physical readiness.
- Unable to meet one or more
standards.
physical readiness standards.
(NOB)
Midterm
Final
18.
- Fails to live up to Navy
- Always lives up to Navy Core
- Exemplifies Navy Core Values:
Character, Conduct,
Core Values: Honor,
Values: Honor, Commitment, and
Honor, Commitment, and Courage.
Adherence to Navy
Commitment, and Courage.
Courage.
- Personal behavior clearly marks
Core Values: Honor, - Frequently corrected due to
- Always behaves correctly.
midshipman as superior.
Commitment and
inappropriate behavior.
Courage.
(NOB)
Midterm
Final
19.
- Lacks initiative.
- Takes initiative to meet goals.
- Develops innovative ways to
Mission
- Unable to plan or prioritize.
- Plans/Prioritizes effectively.
accomplish goals.
Accomplishment,
- Fails to get the job done.
- Always gets the job done.
- Plans/prioritizes with exceptional
Academic Effort,
- Sets unrealistic or
- Academic achievement clearly
skill and foresight.
Initiative: taking
unchallenging goals.
demonstrates effort.
- Gets job done earlier and better
initiative, planning,
- Academic achievement has
than expected.
prioritizing,
caused midshipman to
- Sustained superior effort.
achieving goals.
receive a PRB.
- Significant upward trend over
previous semester.
(NOB)
Midterm
Final
EVALUATION REPORT & COUNSELING RECORD (cont’d)
20.
Leadership/
Followership,
Management,
Organization,
motivation to
develop others to
accomplish goals.
- Fails to motivate, train, or
develop subordinates.
- Fails to organize, creates
problems for subordinates.
- Lacks the ability to cope
with or tolerate stress.
- Effectively motivates, trains and
develops subordinates.
- Organizes successfully, solves
problems as they occur.
- Performs well in stressful
situations.
- Inspiring motivator and trainer.
- Superb organizer, great foresight,
gets ahead of problems.
- Perseveres through the toughest
challenges.
(NOB)
Midterm
Final
21. Growth Potential: Below Standards
Progressing
Meets Standards
Above Standards
Exceeds Standards
22. Billet Recommendations:
23. Comments on Performance (Primary Grader)
24. Comments on Performance (Secondary Grader)
25. Comments on Performance (Officer/Instructor)
Academic Term GPA:
26. Student
Ranking
Individual
Summary
Fourth Tier
NOB
Bottom Tier
Overall Aptitude Grade:
Middle Tier
Second Tier
Top Tier
N/A
27. Signature of Commanding Officer
Date
28. Signature of Student Evaluated
Date
Statement Provided