Form Nscadm 017 - Officer / Midshipman / Instructor Evaluation Report - U.s. Navy League Cadet Corps

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OFFICER / MIDSHIPMAN / INSTRUCTOR
U.S. NAVAL SEA CADET CORPS
FOR OFFICIAL USE ONLY
U.S. NAVY LEAGUE CADET CORPS
EVALUATION REPORT
INSTRUCTIONS
1.
Complete this form in the following instances:
a.
Promotion Board recommendation to LT and LCDR or administrative promotion to ENS, LTJG and WO.
b.
Annual evaluation on 31 MAR, see NSCC Regulation, Chapter ELEVEN and NSCC/NLCC Administrative Manual, Chapter TWO for guidance.
c.
Separation for retirement or disciplinary reasons or transfer to inactive statues, another unit, or regional staff.
d.
May be used by COTCs to document Escort Officer performance, but not required.
2. PERSONNEL INFORMATION
2a. Last Name
2b. First Name
2c. Social Security Number
2d. Unit Name
2e. Region
2f. Current Rank
2g. Height/Weight
2h. Occasion for Report
2i. Reporting Period
From:
To:
Promotion
Annual
Transfer
Training/Escort Officer
3. PROFESSIONAL EXPERIENCE
3a. Date of Present Rank
3b. Time in NSCC (years)
3c. If Unit CO, Date Appointed
3d. Primary Billet
3e. Collateral Duty Billet(s)
3f. Service at RTC/Orientation?
3g. Officer Professional Development Completed
Yes
No
If Yes, Location/Year:
OPD 101
OPD 201A
OPD 210T
OPD 301
3h. Escort Duty (during reporting period)
Type Training
Location
Days
Date (MMM YY)
4. UNIT ACHEIVEMENTS (during reporting period)
4a. Narrative of Achievements
4c. Enrollment
4b. Annual Inspection Score
LCDR:
LT:
LTJG:
ENS:
WO:
MIDN:
INST:
NSCC:
NLCC:
5. PERFORMANCE TRAITS
NOB – Not Observed; 1.0 – Below Standard; 2.0 – Progressing; 3.0 – Meets all Standards; 4.0 – Above Standards (All 1.0 marks must be justified in comments section)
NOB
1.0
2.0
3.0
4.0
COMMENTS
AREA OF EVALUATION
5a. Knowledge of NSCC/NLCC Program
5b. Performance of Primary Duties
5c. Instructor Ability
5d. Performance and a TWT Escort Officer
5e. Administrative Ability
5f. Recruiting and Retention Ability
5g. Leadership/Command Ability
5h. Military Bearing and Appearance
5i. Personal Conduct
5j. Attendance
Note: Score equals average of all scores less NOBs
5k. Overall Evaluation Score
NSCADM 017 (Rev 01/09)
PREVIOUS EDITIONS ARE OBSOLETE
Formerly NSC-17

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