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PFT/CFT PERFORMANCE WORKSHEET

FOR OFFICIAL USE ONLY Privacy sensitive when filled in. Any misuse or unauthorized disclosure may result in both civil and criminal 1 of 2 AEM Designer PERFORMANCE WORKSHEET AUTHORITY: 10 5013, Secretary of the Navy; 10 5041, Headquarters, Marine Corps; 10 1074f, Medical Tracking System for Members Deployed Overseas; 32 CFR , Management and Mobilization; DoDI , Reserve Component (RC) Member Participation Policy; DoDI , Personnel Accountability in Conjunction with Natural and Manmade Disasters; CJCSM , Joint Reporting Structure Personnel Manual; DoDI , Deployment Health; SECNAVINST , Management and Disposition of Line of Duty Benefits for Members of the Navy and Marine Corps Reserve; MCO B, Marine Corps Policy for paying Reserve Marines; 9397 (SSN), as amended; and SORN M01040-3. PRINCIPAL PURPOSE: Information collected by this form will be used to record physical fitness PERFORMANCE data for compliance with the Marine Corps Physical Fitness and Combat Fitness program and will be entered in Marine Corps Total Force System (MCTFS).

PFT/CFT Performance Worksheet. Unit Date Monitor Individual Data PFT Performance Data CFT Performance Data Rank First Name MI Last Name EDIPI Age* Gender Height Weight Pull Ups Score Score 3 Mile Run Score PFT Total MTC Time AL Reps MANUF Time Pass/Fail. NAVMC 11622 (Rev. 01-20) (EF) *Note: Risk Factor Worksheet required for Marines age 46 …

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