<p> EVALUATION REPORT & COUNSELING RECORD 1. Name (Last, First MI suffix) 2. Class Year 3. Company-PLT-SQD</p><p>4. Period of Report 5. Type of Report Fall Winter Year Regular Special 6. PFA/PFT Date 7. Ht/Wt 8. Swim Qualification WS NS None 1st 2nd 3rd 9. Billet Assigned: 10. Major: </p><p>11. Awards / NROTC Extracurricular Activities: 12. Community Service Activities: 13. Date Midterm Counseling Completed 14. Name of Midterm Counselor 15. Signature of Individual Counseled</p><p>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. (* Must be specifically justified) PERFORMANCE 1.0* 2.0 3.0 4.0 5.0 TRAITS Below Standards Progressing Meets Standards Above Greatly Exceeds Standards 16. Equal - Displays personal bias - Always treats others - Admired for fairness and Opportunity: or engages in harassment with fairness and respect. human respect. Fairness, respect - Lacks respect for EO - Does not condone bias - Ensures a climate of fairness for Human Worth. objectives. or harassment in or and respect for human worth. - Interferes with order outside the battalion. - Leader and model and discipline by - Positively contributes contributor to unit disregarding rights of to unit morale and cohesiveness and morale. others. cohesiveness.</p><p>17. Organizational - Creates conflict, - Reinforces others’ - Team builder, inspires Support: unwilling to work with efforts, meets personal cooperation and progress. Contributions others, puts self above commitments to team. - Talented mentor, focuses towards team team. - Understands team goals and techniques for team. building and team - Fails to understand goals, employs good - The best at accepting and results. team goals or teamwork teamwork techniques. offering team direction. Communication techniques. - Accepts and offers - Volunteers for almost skills. - Does not take direction team direction. everything. well. - Will volunteer if asked - Finds excuses to get to. out of battalion activities.</p><p>18. Military - Unsatisfactory - Excellent personal - Exemplary personal Bearing/ demeanor or conduct. appearance. appearance. Appearance, - Consistently - Excellent demeanor or - Exemplary personal Physical fitness unsatisfactory conduct. demeanor or conduct. appearance. - Complies with physical - Excellent or outstanding - Unable to meet one or readiness program, PRT. A leader in physical more physical readiness within all standards. readiness. standards.</p><p>19. Character, - Fails to live up to Navy - Always lives up to - Exemplifies Navy Core Conduct: Core Values: Honor, Navy Core Values: Values: Honor, Commitment, Adherence to Courage, and. Honor, Commitment, and Courage. Navy Core Commitment. and Courage. - Personal behavior clearly Values: Honor, - Frequently corrected - Always behaves marks midshipman as Courage, due to inappropriate correctly. superior. Commitment,. behavior.</p><p>EVALUATION REPORT & COUNSELING RECORD (cont’d) PERFORMANCE 1.0* 2.0 3.0 4.0 5.0 TRAITS Below Standards Progressing Meets Standards Above Greatly Exceeds Standards 20. Mission - Lacks initiative - Takes initiative to - Develops innovative ways to Accomplishment, - Unable to plan or meet goals. accomplish goals. Academic effort, prioritize. - Plans/prioritizes - Plans/prioritizes with Initiative: Taking - Fails to get the job effectively. exceptional skill and foresight. initiative, done. - Always gets the job - Gets job done earlier and planning, - Sets unrealistic or done. better than expected. prioritizing, and unchallenging goals. - Academic - Sustained superior effort. achieving goals. - Academic achievement achievement clearly - Significant upward trend has caused midshipman demonstrates effort. over previous semester. to receive a PRB (second consecutive offense).</p><p>21. Leadership/ - Fails to motivate, train, - Effectively motivates, - Inspiring motivator and Followership, or develop subordinates. trains and develops trainer. Management: - Fails to organize, subordinates. - Superb organizer, great Organizing, creates problems for - Organizes foresight, gets ahead of Motivating, and subordinates. successfully, solves problems. Developing others - Lacks the ability to problems as they occur. - Perseveres through the to accomplish cope with or tolerate - Performs well in toughest challenges. goals stress. stressful situations.</p><p>22. Comments on Performance (Rater) : </p><p>Name of Rater: 23. Comments on Performance (Senior Rater) :</p><p>Name of Senior Rater: 24. Comments on Performance (Class Advisor) :</p><p>Significant Must Early Promotion Recommendation Progressing Promotable Problems Promote Promote Individual Summary </p><p>Peer Score Academic Term GPA Cum. GPA Signature of Class Advisor Aptitude Grade 25. Signature of Commanding Officer 26. Signature of Midshipman Evaluated Statement provided </p><p>Revised 12/2004</p>