Da 1059 Form PDF Details

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QuestionAnswer
Form NameDa 1059 Form
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other names1059 form, army 1059 form, da 1059, 1059 army

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SERVICE SCHOOL ACADEMIC EVALUATION REPORT

 

DATE (YYYYMMDD)

 

 

 

 

 

 

 

For use of this form, see AR 623-3; the proponent agency is DCS, G-1.

 

 

 

 

1. LAST NAME - FIRST NAME - MIDDLE INITIAL

2. SSN

 

3. GRADE

4. BR

5. SPECIALTY/MOSC

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

6. COURSE TITLE

 

 

 

 

 

 

 

 

7. NAME OF SCHOOL

 

 

 

8. COMP

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

9. THIS IS A REFERRED REPORT, DO YOU WISH TO MAKE

10. DURATION OF COURSE (YYYYMMDD)

 

 

COMMENTS?

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

YES

 

NO

From:

 

 

 

 

Thru:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

11. PERFORMANCE SUMMARY

 

 

 

12. DEMONSTRATED ABILITIES

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

WRITTEN COMMUNICATION

 

 

 

 

 

 

EXCEEDED COURSE STANDARDS

 

 

NOT EVALUATED

UNSAT

SAT

SUPERIOR

 

 

 

 

 

 

 

 

 

 

(Limited to 20% of class enrollment)

 

ORAL COMMUNICATION

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

NOT EVALUATED

UNSAT

SAT

SUPERIOR

 

 

 

 

ACHIEVED COURSE STANDARDS

 

LEADERSHIP SKILLS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

NOT EVALUATED

UNSAT

SAT

SUPERIOR

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

MARGINALLY ACHIEVED COURSE STANDARDS

 

CONTRIBUTION TO GROUP WORK

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

NOT EVALUATED

UNSAT

SAT

SUPERIOR

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

FAILED TO ACHIEVE COURSE STANDARDS

 

EVALUATION OF STUDENT'S RESEARCH ABILITY

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

NOT EVALUATED

UNSAT

SAT

SUPERIOR

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

*Rating must be supported by comments in ITEM 14.

 

(SUPERIOR/UNSAT rating must be supported by comments in ITEM 14)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

13. HAS THE STUDENT DEMONSTRATED THE ACADEMIC POTENTIAL FOR SELECTION TO HIGHER LEVEL SCHOOLING/TRAINING?

 

 

 

 

YES

 

 

 

NO

 

N/A (A "NO" response must be supported by comments in ITEM 14)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

14. COMMENTS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

15. AUTHENTICATION

 

 

 

 

a. TYPED NAME, GRADE, BRANCH, AND TITLE OF RATER

 

DATE (YYYYMMDD)

 

SIGNATURE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

b. TYPED NAME, GRADE, BRANCH, AND TITLE OF REVIEWING OFFICER

DATE (YYYYMMDD)

 

SIGNATURE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

c. DATE (YYYYMMDD)

 

 

SIGNATURE OF RATED SOLDIER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DA FORM 1059, MAR 2006

PREVIOUS EDITIONS ARE OBSOLETE.

APD v1.00

 

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