SPECIALIST/CORPORAL PROMOTION EVALUATION REPORT FY 2011

PART I - ADMINISTRATIVE DATA

a. NAME (Last, First, Middle Initial) b. SSN c. RANK d. DATE OF RANK e. PMOSC

SPC 11B10
f. UNIT, ORG., STATION, ZIP CODE OR APO, MAJOR COMMAND g. REASON FOR SUBMISSION
CO A 1ST BN 1110TH INF, INDIANA, PA 15701 PAARNG Board Action
PART II - AUTHENTICATION
a. NAME OF RATER (Last, First, Middle Initial) SSN SIGNATURE

RANK, ORGANIZATION, DUTY ASSIGNMENT DATE

SGT, 11B20, CO A 1ST BN 110TH INF, FIRE TEAM LEADER
b. NAME OF SENIOR RATER (Last, First, Middle Initial) SSN SIGNATURE

RANK, ORGANIZATION, DUTY ASSIGNMENT DATE

SSG, 11B30, CO A 1ST BN 110TH INF, SQUAD LEADER
c. RATED SOLDIER: SIGNATURE DATE

PART III - DUTY DESCRIPTION (Rater)

a. PRINCIPAL DUTY TITLE b. DUTY MOSC
11B10
c. DAILY DUTIES AND SCOPE (To include, as appropriate, people, equipment, facilities and dollars)
Assists in the performance of reconnaissance operations. Employs, fires, and recovers anti-personnel and anti-tank mines. Locates and
neutralizes mines. Operates, mounts/dismounts, zeros, and engages targets using night vision sight. Operates and maintains
communications equipment and operates in a radio net. Operates in a NBC contaminated area. Constructs field expedient firing aids
for infantry weapons. Processes prisoners of war and captured documents
d. APPOINTED DUTIES

PART IV - ARMY VALUES/ATTRIBUTES/SKILLS/ACTIONS (Rater)

a. ARMY VALUES. Check either “YES” or “NO”. (Comments are mandatory for “No” entries; optional for “Yes” entries.) YES NO
1. LOYALTY: Bears true faith and allegiance to the U.S. Constitution, the Army, the unit, and other soldiers .
2. DUTY: Fulfills their obligations

V Loyalty 3. RESPECT/EO/EEO: Treats people as they should be treated.

Duty 4. SELFLESS-SERVICE: Puts the welfare of the nation, the Army, and subordinates before their own .

A Respect 5. HONOR: Lives up to all the Army values.

6. INTEGRITY: Does what is right – legally and morally.
Selfless-Service
L 7. PERSONAL COURAGE: Faces fear, danger, or adversity (physical and moral).
Bullet comments

U
Honor
Integrity E
Personal Courage
S

MA-MP FORM 4105-R, 1 NOV 06

Specialist Evaluation Report. For soldiers in the rank of SPC, a Specialist Evaluation Report will be prepared at unit level
and attached to the 4100 when forwarded for consideration. The evaluation report will provide valuable information to board members
as they review files and conduct appearance boards since these soldiers have not received an initial NCOER. These “Board Action”
evaluation reports should follow the normal bullets rules, but may be hand written. The evaluated soldier will sign the completed
evaluation and should be counseled on their performance/potential.
RATED SOLDIERS’S NAME (Last, First, Middle Initial) SSN FY
. 2011
Specific Bullet examples of “EXCELLENCE” or “NEEDS IMPROVEMENT” are mandatory.
Specific Bullet examples of “SUCCESS” are optional.
PART IV (Rater) – VALUES/NCO RESPONSIBILITIES
b. COMPETENCE      
o Duty proficiency; MOS competency
o Technical & tactical; knowledge, skills, and
abilities
o Sound judgment
o Seeking self-improvement; always learning
o Accomplishing tasks to the fullest capacity;
committed to excellence
EXCELLENCE SUCCESS NEEDS IMPROVEMENT
(Exceeds Std) (Meets std) (Some) (Much)

APFT : HEIGHT/WEIGHT
c. PHYSICAL
o Mental andFITNESS
physical & MILITARY BEARING
toughness
o Endurance and stamina to go the distance
o Displaying confidence and enthusiasm;
looks like a soldier

EXCELLENCE SUCCESS NEEDS IMPROVEMENT

(Exceeds Std) (Meets std) (Some) (Much)

     
d. LEADERSHIP
o Mission first
o Genuine concern for the soldiers
o Instilling the spirit to achieve and win
o Setting the example; Be, Know, Do

EXCELLENCE SUCCESS NEEDS IMPROVEMENT

(Exceeds Std) (Meets std) (Some) (Much)

     
e. TRAINING
o Individual and team
o Mission focused; performance oriented
o Teaching soldiers how; common tasks,
duty-related skills
 Sharing knowledge and experience to fight,
survive and win
EXCELLENCE SUCCESS NEEDS IMPROVEMENT
(Exceeds Std) (Meets std) (Some) (Much)

     
f. RESPONSIBILITY & ACCOUNTABILITY
o Care and Maintenance of equipment/facilities
o Soldier and equipment safety
o Conservation of supplies and funds
o Encouraging soldiers to learn and grow
o Responsible for good, bad, right & wrong
EXCELLENCE SUCCESS NEEDS IMPROVEMENT
(Exceeds Std) (Meets std) (Some) (Much)

PART V - OVERALL PERFORMANCE AND POTENTIAL

a. RATER. Overall potential for promotion and/or e. SENIOR RATER BULLET COMMENTS
service in positions of greater responsibility.

AMONG THE FULLY

BEST CAPABLE MARGINAL

b. RATER. List 3 positions in which the rated

NCO could best serve the Army at his/her
current or next higher grade.

Team Leader
Instructor
Section Leader

c. SENIOR RATER. Overall performance d. SENIOR RATER. Overall potential

for promotion and/or service in
1 2 3 4 5 positions of greater responsibility. 1 2 3 4 5
Successful Fair Poor Superior Fair Poor

MA-MP FORM 4105-R, 1 NOV 06