A2 1

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A2 1

  1. 1. PERSONNEL QUALIFICATION RECORD (Cont.) NAME: SECTION II - CLASSIFICATION AND ASSIGNMENT DATA (Cont.) SECTION III - SERVICE, TRAINING AND OTHER DATES13. PILOT RATINGS 18. APPOINTMENTS AND REDUCTIONS CONT 19. SPECIALIZED TRAINING CONT ORIGINAL DATE CURRENT DATE EFFECTIVE DATE OF SUBJECT DATE GRADE COMP DATE ELIG./RANK ATP 21-114 (BCT)14. FLYING STATUS CONT Geneva-Hague Conventions Military JusticeINSTRUMENT CERTIFICATION Benefits of Honorable15. INTERNSHIPS, RESIDENCIES AND FELLOWSHIPS CONT Discharge HOSPITAL TYPE OF SERVICE MONTHS YEAR16. HOSPITAL/TEACHING APPOINTMENTS AND PRIVATE PRACTICE CONT 20. BASIC ENLISTED SERVICE DATE (BESD) FROM THRU INSTITUTION/LOCATION TYPE DURAT 21. TIME LOST (Sec. 972, Title 10, USC) CONT FROM THRU DAYS REASON SECTION IV - PERSONAL AND FAMILY DATA17. CIVILIAN EDUCATION AND MILITARY SCHOOLS CONT 22. PHYSICAL STATUS 23. PLACE OF BIRTH AND CITIZENSHIP SCHOOL MAJOR/COURSE/MOSC DURAT COMP YEAR HEIGHT WEIGHT GLASSES SELF YES NO SPOUSE DATE OF EXAM CITIZENSHIP OF SPOUSE 24. NUMBER OF DEPENDENTS 25. HOME OF RECORD/ADDRESS ADULT CHILDREN 26. CIVILIAN OCCUPATION JOB TITLE: DOT CODE CRITICAL OCCUPATION NO. MONTHS MOSC EMPLOYED YES NO DUTIES PERFORMED EMPLOYERDA FORM 2-1, MAR 2008 APD PE v2.00 PAGE 2 OF 4
  2. 2. PERSONNEL QUALIFICATION RECORD (Cont.) NAME: SECTION V - MISCELLANEOUS27. REMARKS 28. ITEM CONTINUATION ITEM DATA NO. SECTION VI - RESERVE COMPONENT DATA (YYYYMMDD) 31a. 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: 32. DATE 33. SIGNATURE29. DATE DA FORM 20B OR DA FORM 2-2 PREPARED: (YYYYMMDD) PREPARED REVIEWED30. DATE DUPLICATE DA FORM 2-1 SUBMITTED: (YYYYMMDD) APD PE v2.00DA FORM 2-1, MAR 2008 PAGE 3 OF 4
  3. 3. PERSONNEL QUALIFICATION RECORD (Cont.) NAME: SECTION VII - CURRENT AND PREVIOUS ASSIGNMENTS34. RECORD OF ASSIGNMENTS CONT NON- NON- EFFECTIVE DUTY RATED ORGANIZATION AND STATION DAYS DAYS TYPE DATE DUTY MOSC PRINCIPAL DUTY OR OVERSEA COUNTRY BP EP REPORT (YYYYMMDD) YYYY/MM YYYY/MMDA FORM 2-1, MAR 2008 APD PE v2.00 PAGE 4 OF 4

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