- BUPERSINST 1610.10 (series), Navy Performance Evaluation and Counseling System, 2005, Exhibit 18-1.
ENLISTED EVALUATION REPORT INPUT SHEET
1. Administrative data
- Full name (indicate if changed during period)
Geoffrey David Fuller
- Rate and warfare/qualification designator(s) (Indicate if frocked or selectee)
OS2(SW/AW)
- Social security number
XXX-XX-XXXX
- USN or USNR
USN
- Date reported to present command
10 JAN 11
- Ending date of last regular report
14 MAR 11
- Date of rate
15 JUN 05
2. Duties assigned and number of months assigned during this report period, listed by duty title
- Division, Air Crew, etc. to which assigned
N3 Future Exercises
- Primary duties
N3F Slider Manager
- Collateral duties
Multi-Cultural Committee (President)-9, MWR-9, N3 Portal Manager, COMMNECC Mentor-12, CTT-7, Bayside Middle School Mentor-12
- Watch standing duties
ASDO-12, Quarterdeck-12
- TEMADD/TEMDU (where, when, and why)
- Significant periods not available for duty, if any
If first report at this command, include any delay or TEMDU prior to reporting. Do not include brief illness or normal leave.
None to report
Job information
- Principal activities and responsibilities
N3F Slider Manager
- Include equipment operated or qualified to operate and “customers” served, if applicable.
None to report
Individual accomplishments, including experience gained and contributions to team achievements.
Bachelor’s Degree, Spearheaded Community Service partnership with Church of the Holy Family
- Responsibilities for classified material
Daily basic usage
4. Supervision and leadership
- Personnel directly supervised
None to report.
- Personnel supervised through subordinates
None to report.
- Equipment and material for which responsible
Secret material
- Size of budget managed
None to report
- Leadership activities and accomplishments.
Spearheaded Community Service partnership with Church of the Holy Family, President of Multi Cultural Committee
- Performance as instructor (classroom or on-the-job)
CTT, Petty Officer Indoc
- Counseling given (formal or informal)
None to report
- Retention efforts and results
None to report
5. Special achievements
- Qualifications achieved during period (or during prior period if not mention in previous report)
None to report
- Educational courses completed and diplomas or certificates awarded
Bachelor’s Degree (University of Memphis)
- Personal awards and letters of commendation or appreciation received
Good Conduct award (2nd)
- Off-duty activities
Educational courses attended
- Civic activities
Bayside Middle School Community Service projects
- Voluntary public relations on behalf of the Navy
None to report
- Reservist’s civilian employment
None to report
Note promotions or special accomplishments during period.
- Future duties/schools desired
Instructor Duty, Master Training Specialist Program
- Other items for consideration
Consideration for flight/control time at NAS Oceana to maintain AIC proficiency