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INTERNATIONAL STUDENT ACADEMIC REPORT
(For International Military Students attending CONUS schools.)
(See AR 12-15, AFJI 16-105, and SECNAVINST 4950.4 for forms completion instructions.)
1. ADDRESS (Subsequent training, if applicable, or
country SAO)
2. (Training installation preparing form)
3. (Last, First, Middle Initial) 4. 5. 6. OR IMET FY AND
WCN
11. DID STUDENT COMPLETE
COURSE?
(X one)
12. STUDENT WAS AWARDED: (X one)
10. DURATION OF COURSE
7. 8. 9.
a. (YYMMDD) b. (YYMMDD)
YES
NO (Explain in Item 15)
a. OF COMPLETION
b. OF ATTENDANCE
c. (Explain in Item 15)
13. ENGLISH COMPREHENSION LEVEL
(Enter test score)
a. TEST b. TEST
14. STUDENT'S ACADEMIC EVALUATION
a. SCALE (Enter in Items
14.b. and 14.c.)
1
2
3
4
b. PROFICIENCY
(1) COMPREHENSION
(2) SPEAKING
(3) READING
(4) WRITING
c. IN CLASS
ITEM RATING
(1) ATTITUDE AND MOTIVATION
(2) ATTENDANCE AND PUNCTUALITY
(3) ABILITY TO GRASP INSTRUCTION
(4) PERFORMANCE IN PRACTICAL EXERCISES
(5) PARTICIPATION IN CLASS ACTIVITIES
(6) POTENTIAL AS INSTRUCTOR
(If applicable)
15. REMARKS ON ACADEMIC PERFORMANCE, AWARDS, AND OTHER INFORMATION (Use back if more space is required)
16. REMARKS ON STUDENT'S PARTICIPATION IN EXTRACURRICULAR AND COMMUNITY AFFAIRS (On and off training installation)
(Use back if more space is required)
17. EVALUATOR
a. (Last, First, Middle Initial) b. c.
18. INTERNATIONAL MILITARY STUDENT OFFICER
a. (Last, First, Middle Initial) b. c.
5
(Explain in Item 15)
6 OBSERVED
(Explain in Item 15)
FORWARDING FROM
STUDENT NAME GRADE/RANK COUNTRY FMS CASE
COURSE TITLE COURSE ID NO. COURSE MASL
FROM TO
DIPLOMA/CERTIFICATE
CERTIFICATE
OTHER
IN-COUNTRY CONUS
RATINGS
EXCEPTIONAL
EXCELLENT
VERY SATISFACTORY
SATISFACTORY
LANGUAGE PERFORMANCE
NAME GRADE SIGNATURE
NAME GRADE SIGNATURE
UNSATISFACTORY
NOT
DD FORM 2496, FEB 96
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