Fillable Form 1.: EVALUATION WORKSHEET POTENTIAL ARMY JUNIOR ROTC

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Form 1.: EVALUATION WORKSHEET POTENTIAL ARMY JUNIOR ROTC

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g. SPECIFY SERVICE (S) OF JROTC UNITS
DATE
a. NAME OF SCHOOL
c. TYPE OF INSTITUTION
e. ACCREDITATION EVALUATION BY
(1) Name
(3) Telephone Number
(1) Name
(3) Telephone Number
h. GRADE LEVELS i. STUDENT CAPACITY j. SCHOOL'S STUDENT/TEACHER RATIO
Estimated JROTC Enrollment:
l. PERCENTAGE OF GRADUATES ENTERING COLLEGE
(approximately)
a. TYPE OF COMMUNITY b. SIZE OF COMMUNITY
For use of this form, see AR 145-2; the proponent agency is DCSPER
b. ADDRESS OF SCHOOL (If P.O. Box must also provide a street address for
shipping purposes)
SCHOOL INFORMATION
DA FORM 7410, MAR 2000
APD LC v1.01ES
1.
d. DATE OF LAST ACCREDITATION
EVALUATION
(2) Address
g. PRINCIPAL INFORMATION
(2) Address
k. ENROLLMENT
Grade Male Female Total
9th
10th
11th
12th
Total
YES NO
YES NO
COMMUNITY AND ENVIRONMENT
2.
c. ARE STUDENTS BUSED?
IF SO, ARE THERE ACTIVITY BUSES?
YES NO
YES NO
YES NO YES NO
f. SUPERINTENDENT INFORMATION
EVALUATION WORKSHEET
POTENTIAL ARMY JUNIOR ROTC PROGRAM
The public reporting burden for this collection of information is estimated to average one hour per response, including the time for reviewing instructions, searching existing data sources,
gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection
of information, including suggestions for reducing the burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports , 1215
Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302. Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for
failing to comply with a collection of information if it does not display a currently valid OMB control number. Please DO NOT RETURN your form to the above address. Send your form to the
appropriate ROTC Region.
Where insufficient space is provided on this form to record complete observations, comments or recommendations, additional blank sheets will be used, identifying
items by corresponding number.
m. HAS THE SCHOOL EVER APPLIED FOR A JROTC PROGRAM SUPPORTED BY ANOTHER SERVICE?
IF SO, WHAT IS THE STATUS OF THAT APPLICATION?
n. HAS A JROTC PROGRAM EVER BEEN DISESTABLISHED AT THIS SCHOOL?
IF SO, WHEN AND WHY.
e. WILL JROTC INSTRUCTORS BE PERMITTED TO CONDUCT RECRUITING
VISITS TO FEEDER SCHOOLS?
d. ARE THERE ANY PROBLEMS RELATIVE TO AVAILABILITY OF HOUSING FOR
INSTRUCTORS?
f. NUMBER OF JROTC UNITS IN THE
CITY/DISTRICT
(1) Size (2) Proximity to other JROTC areas (3) Construction
(4) Environmental considerations - heat, humidity, seepage, etc. (5) Security considerations
(1) Describe existing facility area (1) Describe existing facility.
(2) List modification required (2) List modification required
(3) Proximity to other Junior ROTC areas (3) Proximity to other Junior ROTC areas
(1) Outside (2) Inside
(a) Size (a) Size
(b) Proximity to other JROTC areas (b) Proximity to the JROTC areas
(c) Surface conditions
(c) Limitations on use (i.e., gym shoes, rifles prohibited, time available)
(d) Limitation on use
EVALUATION WORKSHEET POTENTIAL ARMY JUNIOR ROTC PROGRAM (Continued)
FACILITIES
3.
Dedicated Sole
Use of
Classrooms
Shared
Classrooms
Administrative
Office Space
(b) Seating Capacity
(c) Type Construction
(e) Lighting
(f) Heating, cooling, ventilation
Dedicated Sole
Use of
Classrooms
Shared
Classrooms
Administrative
Office Space
(g) Noise control
(h) Maintenance of facilities
(i) Storage area for training
aids
(k) Size
(l) Telephone available to SAI
a(1) b(1) c(1) a(2) b(2) c(2)
d. SUPPLY STORAGE AREA
(4) If an area is not currently available, describe plan to provide one to include
method of funding and timeframe for completion.
(4) If a facility is not currently available, describe plan to meet the marksmanship
e. ARMS STORAGE f. MARKSMANSHIP FACILITIES
g. DRILL AREA
PAGE 2, DA FORM 7410, MAR 2000
APD LC v1.01ES
(a) Proximity to the remainder
of the school and to other
JROTC areas.
(d) Type and condition
of furniture
training and competition portion of the program, to include funding, timeframe for
completion, pellet or rifle program.
h. WILL JROTC INSTRUCTORS BE REQUIRED TO JOIN A TEACHERS' UNION?
c. WILL THE SCHOOL PAY JROTC INSTRUCTORS THE MINIMUM, OR DOES THE SCHOOL SYSTEM HAVE PAY SCALES ABOVE THOSE FIGURES?
e. WILL THE JROTC DEPARTMENT BE ALLOCATED A PORTION OF THE SCHOOL'S BUDGET?
WHAT IS THE ESTIMATED ANNUAL FIGURE?
HOW MUCH PER YEAR?
g. WILL JROTC INSTRUCTORS BE REQUIRED TO MEET CERTAIN STANDARDS FOR CERTIFICATION?
h. ARE THE FACILITIES COMPLETELY IDENTIFIED BY THE SCHOOL ON THE DA FORM 3126?
i. MAY INSTRUCTORS RENOVATE FACILITIES IF REQUIRED?
EVALUATION WORKSHEET POTENTIAL ARMY JUNIOR ROTC PROGRAM (Continued)
PAGE 3, DA FORM 7410, MAR 2000
APD LC v1.01ES
PROJECTED SUPPORT
4.
a. IS A RIFLE RANGE A PART OF THE SCHOOL FACILITY?
IF NOT, WHERE IS THE RANGE WHICH WILL BE USED FOR JROTC MARKSMANSHIP INSTRUCTION AND RIFLE TEAM PRACTICE (include on DA Form 3216)?
YES NO
b. WILL THE SCHOOL PROVIDE TRANSPORTATION TO/FROM THE RANGE, DURING REGULAR SCHOOL HOURS, AT ITS OWN EXPENSE (include on DA Form
YES NO
c. WILL SCHOOL PROVIDE TRANSPORTATION, AT ITS OWN EXPENSE, FOR JROTC ACTIVITIES (such as parades, color guard, rifle matches, drill meets) AWAY
FROM THE MAIN CAMPUS?
WITHIN WHAT RADIUS?
YES NO
d. WILL SELECTED RIFLE TEAM/DRILL TEAM MEMBERS BE AWARDED A SCHOOL LETTER?
YES NO
ADMINISTRATION
5.
a. DO SCHOOL OFFICIALS UNDERSTAND THE PROCEDURES FOR PAYMENT/REIMBURSEMENT OF JROTC INSTRUCTORS?
YES NO
b. WHAT LENGTH CONTRACT WILL JROTC INSTRUCTORS BE OFFERED?
11 MONTH 12 MONTH
d. WILL THE SCHOOL PAY JROTC INSTRUCTORS FOR COACHING DUTIES (rifle/drill teams)?
YES NO
YES NO
f. WILL CREDIT BE AWARDED FOR JROTC PARTICIPATION?
WILL THIS CREDIT COUNT TOWARD
YES NO
GPA GRADUATION
YES NO
YES NO
YES NO
YES NO
FACILITIES (Continued)
3126)?
TYPE NAME AND TITLE SIGNATURE DATE
EVALUATION WORKSHEET POTENTIAL ARMY JUNIOR ROTC PROGRAM (Continued)
PAGE 4, DA FORM 7410, MAR 2000
APD LC v1.01ES
LIST VOCATIONAL ELECTIVES AND EVALUATE THE POTENTIAL OF A JROTC PROGRAM TO COMPETE FOR A CROSS SECTION OF THE SCHOOL
ENROLLMENT. (Explain in remarks.)
e.
REMARKSf.
EVALUATING OFFICER
7.
RECOMMEND IMMEDIATE ESTABLISHMENT OF AN ARMY JROTC UNIT AT THIS SCHOOL.a.
b.
RECOMMEND AGAINST ESTABLISHMENT OF AN ARMY JROTC UNIT AT THIS SCHOOL FOR THE REASONS SPECIFIED BELOW.c.
IS SCHOOL ENROLLMENT APPROACHING CAPACITY? (Explain expansion plan in remarks.)
d.
YES NO
RECOMMENDATIONS
6.
THE SCHOOL DOES NOT PRESENTLY HAVE ALL REQUIRED FACILITIES AVAILABLE, BUT SCHOOL AUTHORITIES HAVE AGREED TO PROVIDE SUCH
FACILITIES BEFORE OR DURING THE FIRST YEAR OF JROTC TRAINING, WITHIN THE TIME-TABLE SPECIFIED BELOW. RECOMMEND IMMEDIATE
ESTABLISHMENT OF AN ARMY JROTC UNIT AT THIS SCHOOL.
Please circle "yes" for the equipment listed below the school will provide to the JROTC classrooms:
Classroom computers: Yes / No
Classroom printers: Yes / No
Classroom projection screens: Yes / No
Flat Screen TVs: Yes / No
Interactive White Board: Yes / No
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Form 1.: EVALUATION WORKSHEET POTENTIAL ARMY JUNIOR ROTC

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Completed 7 September 2021

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