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SPECIAL PROGRAM SCREENING NAVPERS 1306/92 …

SPECIAL PROGRAM SCREENING . NAVPERS 1306 /92 (01-2011) Supporting Directive MILPERSMAN 1306 -900. 1. NAME: 2. RATE / RANK: 3. SSN (Last 4): 4. PROPOSED DETACHMENT DATE: 5. PROPOSED PROGRAM / DUTY STATION: SECTION A: GENERAL CRITERIA. INTERVIEWER'S. INITIALS. 1. Within the past 36 months, has member been found unsuitable or disqualified for any previous SPECIAL YES NO. PROGRAM (s)? 2. Performance Evaluation ( NAVPERS 1616/26): Has member received at least on all traits, been YES NO. recommended for retention and promotable or higher for advancement for the past 36 months? 3. Has member had any NJP, courts-martial, civil conviction, or significant involvement with civil authorities YES NO. within the past 36 months? 4. Has member had any alcohol related incidents in the past 36 months? YES NO. 5. Has member had any involvement with illegal drugs in the past 36 months?

SPECIAL PROGRAM SCREENING NAVPERS 1306/92 (01-2011) Supporting Directive MILPERSMAN 1306-900

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