NAME
SSN
PART V - RATED OFFICER CONTRIBUTIONS
a. APFT:
DATE:
HEIGHT:
WEIGHT:
b. LIST YOUR SIGNIFICANT CONTRIBUTIONS:
c. LIST ANY UNIQUE PROFESSIONAL SKILLS OR AREAS OF EXPERTISE OF VALUE TO THE ARMY:
d. IF UNABLE TO SERVE IN THE CURRENT BRANCH/CAREER FIELD, IN WHICH BRANCH/CAREER FIELD WOULD YOU PREFER TO SERVE?
e. LIST 3 FUTURE ASSIGNMENTS FOR WHICH YOU FEEL YOU ARE BEST SUITED:
SIGNATURE AND DATE
Page 2 of 2
DA FORM 67-9-1, OCT 2011
APD PE v1.00ES