SECTION II - CLASSIFICATION AND ASSIGNMENT DATA (Continued)

PERSONNEL QUALIFICATION RECORD

6.

For use of this form, see AR 600-8-104; the proponent agency is DCS, G-1.

MILITARY OCCUPATIONAL SPECIALTIES

MOSC

CONT

TITLE

DATE

SECTION I - IDENTIFICATION DATA

2. S.S.N.

1. NAME (Last, First, MI)

SECTION II - CLASSIFICATION AND ASSIGNMENT DATA

3.

MOS EVALUATION SCORES

MOSC

YR & MO

SCORE

4.

YR & MO

CONT

SCORE

YR & MO

SCORE

ASSIGNMENT CONSIDERATIONS

CONT

7.

AVIATION ASI & GUNNERY QUALIFICATION

AIRCRAFT

5.

OVERSEA SERVICE
FROM

THRU

AREA AND COUNTRY

CONT
MO

TYPE

NTC

INSTR PILOT
F/W

R/W

CONT

GUNNERY SYSTEM

F/W

R/W

TNG

9.

AWARDS, DECORATIONS & CAMPAIGNS

8. APTITUDE AREA SCORES

AREA

SCORE

AREA

CONT
SCORE

INSTR

CONT

DEPN
ARR OS

DATE
PLACE
10.
TEST

OTHER TESTS
DATE

CONT
SCORE

MDBOCT
DLAT
OQI-1
FASTOB
WOCB

11.

AMERICAN BOARD CERTIFICATION &

LICENSES OR CERTIFICATES HELD

CONT
12. LANGUAGE PROFICIENCY
DA FORM 330
DATE
SUBMITTED

DA FORM 2-1, MAR 2008

EDITION OF JAN 1973 IS OBSOLETE.

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PERSONNEL QUALIFICATION RECORD (Cont.)

NAME:

SECTION II - CLASSIFICATION AND ASSIGNMENT DATA (Cont.)

13.

SECTION III - SERVICE, TRAINING AND OTHER DATES

PILOT RATINGS
ORIGINAL

14.

DATE

18.
CURRENT

DATE

FLYING STATUS

CONT 19. SPECIALIZED TRAINING

APPOINTMENTS AND REDUCTIONS

GRADE

EFFECTIVE
DATE

COMP

SUBJECT

DATE OF
ELIG./RANK

CONT
DATE

ATP 21-114 (BCT)

CONT

Geneva-Hague
Conventions
Military Justice
Benefits of
Honorable
Discharge

INSTRUMENT CERTIFICATION
15.

INTERNSHIPS, RESIDENCIES AND FELLOWSHIPS

HOSPITAL

16.

TYPE OF SERVICE

CONT
MONTHS

HOSPITAL/TEACHING APPOINTMENTS AND PRIVATE PRACTICE

FROM

THRU

INSTITUTION/LOCATION

TYPE

YEAR

CONT

20. BASIC ENLISTED SERVICE DATE (BESD)

DURAT

21.

CONT

TIME LOST (Sec. 972, Title 10, USC)

FROM

THRU

DAYS

REASON

SECTION IV - PERSONAL AND FAMILY DATA

17.

CIVILIAN EDUCATION AND MILITARY SCHOOLS

SCHOOL

MAJOR/COURSE/MOSC

CONT
DURAT

COMP

YEAR

22.

PHYSICAL STATUS

HEIGHT

WEIGHT

23.

GLASSES
YES

DATE OF EXAM
24.

26.

NO SPOUSE
CITIZENSHIP OF SPOUSE

NUMBER OF DEPENDENTS
ADULT

PLACE OF BIRTH AND CITIZENSHIP

SELF

25.

HOME OF RECORD/ADDRESS

CHILDREN

CIVILIAN OCCUPATION

JOB TITLE:
DOT CODE

CRITICAL OCCUPATION
YES

NO

NO. MONTHS
EMPLOYED

MOSC

DUTIES PERFORMED

EMPLOYER

DA FORM 2-1, MAR 2008

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PERSONNEL QUALIFICATION RECORD (Cont.)

NAME:

SECTION V - MISCELLANEOUS
27. REMARKS

28.

ITEM CONTINUATION
ITEM
NO.

DATA

SECTION VI - RESERVE COMPONENT DATA

31a.

(YYYYMMDD)

READY RESERVE OBLIGATION EXPIRATION DATE:

b. READY RESERVE START DATE:

c. SERVICE OBLIGATION EXPIRATION DATE:
d. MANDATORY REMOVAL FROM ACTIVE STATUS:
e. RETIREMENT YEAR ENDING DATE:
29. DATE DA FORM 20B OR DA FORM 2-2 PREPARED: (YYYYMMDD)

33. SIGNATURE

DATE

32.
PREPARED

REVIEWED

30. DATE DUPLICATE DA FORM 2-1 SUBMITTED: (YYYYMMDD)

DA FORM 2-1, MAR 2008

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PAGE 3 OF 4

PERSONNEL QUALIFICATION RECORD (Cont.)

NAME:

SECTION VII - CURRENT AND PREVIOUS ASSIGNMENTS

34.
EFFECTIVE
DATE

RECORD OF ASSIGNMENTS
DUTY MOSC

(YYYYMMDD)

DA FORM 2-1, MAR 2008

PRINCIPAL DUTY

CONT
ORGANIZATION AND STATION
OR OVERSEA COUNTRY

NONDUTY
DAYS
BP
YYYY/MM

NONRATED
DAYS
EP
YYYY/MM

TYPE
REPORT

APD LC v2.01ES

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