Appendix G Qe Request Form printable pdf download

Appendix G Qe Request Form

Appendix G of COMDTINST M16794.51A

Appendix G QE Request Form

From: __________________________________________________________________

(FC/FSO-MT/BCTC/SO-MT)

To: ____________________________________________________________________

(Area QE Coordinator)

AQEC Phone No.: ________________________________________________________

Area: _________________________ ____________

Date: ___________________

I am requesting a QE for the following purpose:

Nav Rules Testing:

_____

Operational Excellence: _____

Crew Oral:

_____

Coxswain Oral:

_____

PWC Oral:

_____

Crew Underway:

_____

Coxswain Underway: _____

PWC Underway:

_____

Third Year Crew:

_____

Third Year Coxswain:

_____

Third Year PWC:

_____

The requested time and date is: ______________________________________________

Alternate time and date: ____________________________________________________

Requesting Division/flotilla: ____________

Number of candidates: ___________

Please list candidate names, EMPLID Number, and Division/Flotilla below:

NAME

EMPLID NO.

DIV / FLTA

The Record of completed tasks displays mentor signatures and dates for each task.

The candidate has completed all reading assignments and exercises.

Candidates name and mentor signature and date appear on each task as required.

Candidate possesses proof of completion of special tasks (Nav-Rules, etc.)

Candidate has been trained to the standards set forth in the appropriate publication.

FSO-IS has verified that member is not in REYR for Underway Hours.

_______________________________________________

__________________

NAME OF PERSON MAKING REQUEST

DATE

G-1

Appendix G Qe Request Form

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