Base System Civilian Evaluation Report Page 2
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1
2THRU DATE
RATEE'S NAME (Last, First, Middle Initial)
Specific bullet examples of other than "SUCCESS," are mandatory.
b. RESPONSIBILITIES
Specific bullet examples of "SUCCESS" are optional but encouraged.
1. TECHNICAL COMPETENCE
Technical knowledges, skills, abilities
Doing work right/on time
Sound judgement
EXCELLENCE
SUCCESS
NEEDS
FAILS
(Exceeds std)
(Meets std)
IMPROVEMENT
2. ADAPTABILITY AND INITIATIVE
Adjusting to change - situations/people
Trying new things
Seeking self-development
EXCELLENCE
SUCCESS
NEEDS
FAILS
(Exceeds std)
(Meets std)
IMPROVEMENT
3. WORKING RELATIONSHIPS & COMMUNICATIONS
Supporting team
Respecting others
Expressing ideas clearly
Listening/understanding
NEEDS
EXCELLENCE
SUCCESS
FAILS
(Exceeds std)
(Meets std)
IMPROVEMENT
4. RESPONSIBILITY AND DEPENDABILITY
Dependable/reliable
Maintaining facilities/equipment
Conserving supplies/time
People/equipment safety
NEEDS
EXCELLENCE
SUCCESS
FAILS
(Exceeds std)
(Meets std)
IMPROVEMENT
Numbers 5 and 6 apply to positions with some supervisory duties
5. SUPERVISION AND LEADERSHIP
Mission focused/performance oriented
Sets standard/Leads by example
Motivating/developing others
Implementing DA emphasis programs/managing
resources
EXCELLENCE
SUCCESS
NEEDS
FAILS
(Exceeds std)
(Meets std)
IMPROVEMENT
6. EEO AND AFFIRMATIVE ACTION
Respecting dignity
Achieving planned actions
Providing opportunity
Solving problems
EXCELLENCE
SUCCESS
NEEDS
FAILS
(Exceeds std)
(Meets std)
IMPROVEMENT
PART VI -SENIOR RATER (if used) or
PART VII - SENIOR RATER (If used)
RATER (no senior rater used)
BULLET COMMENTS (Performance/Potential)
OVERALL PERFORMANCE
1
2
3
4
5
SUCCESSFUL
FAIR
UNSUCCESSFUL
(MUST Have Senior
Rater Review)
A completed DA Form 7223-1 was received with this report
and considered in my evaluation and review:
YES
NO (Explain)
APD LC v1.02ES
REVERSE, DA FORM 7223, MAR 2010
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