Road Test Score Sheet - Da Form 6125 (Aug 2011)

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DATE
ROAD TEST SCORE SHEET
For use of this form, see AR 600-55; the proponent agency is DCS, G3/5/7.
NAME OF DRIVER
NAME OF EXAMINER
SSAN
SCORE
ROUTE
STOP/START ON GRADE
EXPRESSWAY
Approach
Merge On
Up
Down
Traffic check
.................................................
Traffic check
.................................................
Signal On
......................................................
Signal On
......................................................
Moves to proper lane
......................................
Maintains spacing
..........................................
Smooth deceleration
.......................................
Avoids stopping
.............................................
Does not coast to stop
...................................
Smooth merge
...............................................
Cancel signal
.................................................
Stop
Lane Changes
Left
Right
Vehicle parallel to curb
...................................
Traffic check
.................................................
Vehicle does not roll
.......................................
Signal on
.......................................................
Signal off/4-ways on
......................................
Adequate spacing
...........................................
Parking brake on
............................................
Smooth lane change
.......................................
Cancel signal
.................................................
Resume
Exit
Traffic check
.................................................
Traffic check
.................................................
4-ways off/signal on
.......................................
Signal on
.......................................................
Release parking brake
.....................................
Smooth merge to exit lane
..............................
Did not stall engine
.........................................
Decelerate in exit lane
....................................
Traffic check
.................................................
Adequate spacing
..........................................
Accelerate to traffic flow
.................................
Correct ramp speed
........................................
Cancel signal
.................................................
SEARCH
.......................................................
SEARCH
.......................................................
DIRECTION
....................................................
DIRECTION
...................................................
SPEED
..........................................................
SPEED
..........................................................
No errors
.......................................................
No errors
......................................................
DRIVING UP GRADE
GENERAL DRIVING BEHAVIOR
Use clutch properly (to shift, double clutched, didn't ride)
............
In proper gear
................................................
Used gears properly (not over-rev/lug engine, clash gears, coast)
..
Stays in right lane
..........................................
Used brakes properly (no hard braking, no riding or pumping
Uses 4-ways if slow
.......................................
brake)
....................................................................................
Traffic check
.................................................
Proper steering (both hands on wheel, not over/under steer)
.........
Obeyed all traffic signs and signals
............................................
SEARCH
.......................................................
Drove without an accident
........................................................
DIRECTION
....................................................
Never put vehicle over sidewalks, lane markings, stop lines, etc.
...
SPEED
..........................................................
Examiner was never thrown to left, right, or forward
...................
No errors
.......................................................
Driver was never forced to take evasive action
...........................
DRIVING DOWN GRADE
Wore seat belt
........................................................................
Yielded right of way to pedestrians
............................................
Clear brakes
..................................................
Yielded right of way to other vehicles, as appropriate
..................
In proper gear
................................................
No errors
................................................................................
Steady braking on grade
.................................
Does not ride clutch
.......................................
NOTES
Maintain steady speed
....................................
Traffic check
.................................................
SEARCH
.......................................................
DIRECTION
....................................................
SPEED
..........................................................
No errors
.......................................................
DA FORM 6125, AUG 2011
APD LC v1.00
PREVIOUS EDITIONS ARE OBSOLETE.

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