EVALUATION REPORT & COUNSELING RECORD (E1 - E6)
RCS BUPERS 1610-1
1. Name (Last, First MI Suffix)
2. Rate
3. Desig
4. SSN
5. ACT FTS INACT AT/ADSW/265
6. UIC
7. Ship/Station
8. Promotion Status
9. Date Reported
Occasion for Report
10. Periodic
Detachment
11. of Individual
Promotion /
12. Frocking
13. Special
Period of Report
14. From:
15. To:
16. Not Observed
Report
Type of Report
17. Regular
18. Concurrent
20. Physical Readiness
21. Billet Subcategory (if any)
22. Reporting Senior (Last, FI MI)
23. Grade
24. Desig
25. Title
26. UIC
27. SSN
For Mid-term Counseling Use. (When completing EVAL
Enter 30 and 31 from counseling worksheet sign 32.)
30. Date Counseled
31. Counselor
32. Signature of Individual Counseled
PERFORMANCE TRAITS: 1.0 – Below standards / not progressing or UNSAT in any one standard; 2.0 – Does not yet meet all 3.0 standards; 3.0 – Meets all 3.0
standards; 4.0 – Exceeds most 3.0 standards; 5.0 – Meets overall criteria and most of the specific standards for 5.0. Standards are not all inclusive.
PERFORMANCE
TRAITS
1.0*
Below Standards
3.0
Meets Standards
2.0
Pro-
gressing
5.0
Greatly Exceeds Standards
4.0
Above
Standards
Technical knowledge
and practical application.
COMMAND OR
ORGANIZATIONAL
CLIMATE/EQUAL
OPPORTUNITY:
33.
34.
35.
36.
- Actions counter to Navy's retention/
reenlistment goals.
- Uninvolved with mentoring or
professional development of subordinates.
- Actions counter to good order and
discipline and negatively affect Command/
Organizational climate.
- Demonstrates exclusionary behavior.
Fails to value differences from
cultural diversity.
- Positive leadership supports Navy's increased
retention goals. Active in decreasing attrition.
- Actions adequately encourage/support
subordinates' personal/professional growth.
- Demonstrates appreciation for contributions of
Navy personnel. Positive influence on
Command climate.
- Values differences as strengths.
Fosters atmosphere of acceptance/
inclusion per EO/EEO policy.
- Measurably contributes to Navy's increased
retention and reduced attrition objectives.
- Proactive leader/exemplary mentor.
Involved in subordinates' personal
development leading to professional growth/
sustained commitment.
- Initiates support programs for military,
civilian, and families to achieve exceptional
Command and Organizational climate.
- The model of achievement.
Develops unit cohesion by valuing differences
as strengths.
- Needs excessive supervision.
- Product frequently needs rework.
- Wasteful of resources.
- Needs little supervision.
- Produces quality work.
Few errors and resulting rework.
- Uses resources efficiently.
- Needs no supervision.
- Always produces exceptional work.
No rework required.
- Maximizes resources.
- Marginal knowledge of rating, specialty
or job.
- Unable to apply knowledge to solve
routine problems.
- Fails to meet advancement/PQS
requirements.
- Strong working knowledge of rating, specialty
and job.
- Reliably applies knowledge to
accomplish tasks.
- Meets advancement/PQS requirements on time.
- Recognized expert, sought out by all for
technical knowledge.
- Uses knowledge to solve complex
technical problems.
- Meets advancement/PQS requirements
early/with distinction.
- Consistently unsatisfactory appearance.
- Poor self-control; conduct resulting in
disciplinary action.
- Unable to meet one or more
physical readiness standards.
- Fails to live up to one or more
Navy Core Values:
HONOR, COURAGE, COMMITMENT.
- Excellent personal appearance.
- Excellent conduct, conscientiously complies
with regulations.
- Complies with physical readiness program.
- Always lives up to Navy Core Values:
HONOR, COURAGE, COMMITMENT.
- Exemplary personal appearance.
- Model of conduct, on and off duty.
- A leader in physical readiness.
- Exemplifies Navy Core Values:
HONOR, COURAGE, COMMITMENT.
NOB
NOB
NOB
NOB
28. Command employment and command achievements
NAVPERS 1616/26 (08-10) FOR OFFICIAL USE ONLY-PRIVACY ACT SENSITIVE.
29. Primary/Collateral/Watchstanding duties. (Enter Primary duty abbreviation in box.)
QUALITY OF WORK:
Standard of work;
value of end product.
Contributing to growth
and development,
human worth,
community.
Appearance, conduct,
physical fitness,
adherence to
Navy Core Values.
37.
PERSONAL JOB
ACCOMPLISHMENT/
INITIATIVE:
Responsibility,
quantity of work.
- Needs prodding to attain qualification or
finish job.
- Prioritizes poorly.
- Avoids responsibility.
- Energetic self-starter. Completes tasks or
qualifications early, far better than expected.
- Plans/prioritizes wisely and with
exceptional foresight.
- Seeks extra responsibility and takes on the
hardest jobs.
NOB
PROFESSIONAL
KNOWLEDGE:
MILITARY BEARING/
CHARACTER:
- Productive and motivated.
Completes tasks and qualifications fully and
on time.
- Plans/prioritizes effectively.
- Reliable, dependable,
willingly accepts responsibility.
Clear Form
Save Form
Not Recommended Recommended
I intend to submit a statement do not intend to submit a statement
NAVPERS 1616/26 (08-10) FOR OFFICIAL USE ONLY-PRIVACY ACT SENSITIVE.
TEAMWORK:
Contributions to
team building and
team results.
LEADERSHIP:
Organizing, motivating
and developing others
to accomplish goals.
EVALUATION REPORT & COUNSELING RECORD (E1 - E6 ) (cont'd)
RCS BUPERS 1610-1
1. Name (Last, First MI Suffix)
2. Rate
3. Desig
4. SSN
PERFORMANCE
TRAITS
1.0*
Below Standards
3.0
Meets Standards
2.0
Pro-
gressing
5.0
Greatly Exceeds Standards
4.0
Above
Standards
41. I recommend this individual for (maximum of two): Assignment in Rating,
Sea Special Programs, Shore Special Programs, Commissioning Programs,
Special Warfare Programs, Rating Instructor Duty, Other. (Be specific.)
43. COMMENTS ON PERFORMANCE. *All 1.0 marks, three 2.0 marks, and 2.0 marks in Block 37 must be specifically substantiated in comments. Comments must be verifiable.
Font must be 10 or 12 pitch (10 to 12 point) only. Use upper and lower case.
Promotion
Recommendation
NOB
Significant
Problems
Progressing
Promotable
Must
Promote
Early
Promote
48. Reporting Senior Address
45.
INDIVIDUAL
46.
SUMMARY
50. Signature of Reporting Senior
Date:
51. Signature of individual evaluated. “I have seen this report, been apprised of my
performance, and understand my right to make a statement.”
Date:
Date:
52. Typed name, grade, command, UIC, and signature of Regular Reporting Senior on Concurrent Report
Summary Group Average:
38.
39.
NOB
- Creates conflict,
unwilling to work with others,
puts self above team.
- Fails to understand team goals or
teamwork techniques.
- Does not take direction well.
- Reinforces others' efforts,
meets commitments to team.
- Understands goals,
employs good teamwork techniques.
- Accepts and offers team direction.
- Team builder,
inspires cooperation and progress.
- Focuses goals and techniques for teams.
- The best at accepting and offering
team direction.
NOB
- Neglects growth/development or welfare
of subordinates.
- Fails to organize, creates problems
for subordinates.
- Does not set or achieve goals relevant to
command mission and vision.
- Lacks ability to cope with or
tolerate stress.
- Inadequate communicator.
- Tolerates hazards or unsafe practices.
- Effectively stimulates growth/development in
subordinates.
- Organizes successfully, implementing
process improvements and efficiencies.
- Sets/achieves useful, realistic goals
that support command mission.
- Performs well in stressful situations.
- Clear, timely communicator.
- Ensures safety of personnel and equipment.
- Inspiring motivator and trainer, subordinates
reach highest level of growth and development.
- Superb organizer, great foresight, develops
process improvements and efficiencies.
- Leadership achievements dramatically further
command mission and vision.
- Perseveres through the toughest challenges
and inspires others.
- Exceptional communicator.
- Makes subordinates safety-conscious,
maintains top safety record.
- Constantly improves the personal and
professional lives of others.
Font
40. Individual Trait Average.
Total of trait scores divided by
number of graded traits.
42. Signature of Rater (Typed Name & Rate): I have evaluated this member against
the above performance standards and have forwarded written explanation of marks
of 1.0 and 5.0.
Date:
44. QUALIFICATIONS/ACHIEVEMENTS - Education, awards, community involvement, etc., during this period.
47. Retention :
49. Signature of Senior Rater (Typed Name & Grade/Rate): I have reviewed the evaluation of this
member against these performance standards and have provided written explanation to support
marks of 1.0 and 5.0.
Date:
10
