DA Form 4856 Developmental Counseling Example

PART II - BACKGROUND INFORMATION
Purpose of Counseling To discuss duty performance for the period 9 March 2010 to 12 June 2010. To discuss short-range professional growth and plans for the next year. Talk about long-range professional growth (2-5 years) and goals.
PART III - SUMMARY OF COUNSELING Complete this section during or immediately subsequent to counseling.
Key Points of Counseling Performance (sustain): - Emphasized safety. knowledge of demolitioris, and tactical proficiency on the Platoon Live Fire Exercises. - Took charge of company defense during the last major field training exercise, outstanding integration and use of engineers, heavy weapons, and air defense artillery assets in a combined arms environment. Superb defense preparation and execution. - No dropped white-cycle taskings - Good job coordinating with the battalion adjutant on legal and personnel issues. - Continue to take care of Soldiers; keep the commander abreast of problems - Focused on subordinate NCO development: putting the right NCO in the right job. Improve: - Get NCOPDS on the calendar - Hold NCOs to standard on Sergeants’ Time Training. Counseling
OTHER INSTRUCTIONS This form will be destroyed upon: reassignment (other than rehabilitative transfers), separation at ETS, or upon retirement. For separation requirements and notification of loss of benefits/consequences see local directives and AR 635-200.

DA FORM 4856-E, JUN 99 EDITION OF JUN 85 IS OBSOLETE
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Plan of Action: Developmental Plan (next year): - Develop a year-long plan for NCOPDs: place on the calendar and training schedules. - Resume civilian education and correspondence courses. - Develop a company Solder of the month competition. - Assist the company XO in the reorganization of the supply room to improve efficiency of EDRE load-outs. - Put in place a program to develop Ranger School Candidates Long Range goals (2-5 years): - Complete Bachelors degree program - Attend Sergeant Majors Academy
Session Closing: (The leader summarizes the key points of the session and checks to ensure the subordinate understands the plan of action. The subordinate agrees/disagrees and provides remarks if appropriate) Individual counseled: I agree / disagree with the information above Individual counseled remarks: space space Signature of Individual Counseled: ____________________________________ Date: ___15 Jun 2010__
Leader Responsibilities: : (Leader’s responsibilities in implementing the plan of action) I will ensure that your Chain of Command is informed you are being counseled and will provide guidance and assistance whenever you request it or need it. space Signature of Counselor: ____________________________________ Date: ___15 Jun 2010__
PART IV - ASSESSMENT OF THE PLAN OF ACTION
Assessment: (Did the plan of action achieve the desired results? This section is completed by both the leader and the individual counseled and provides useful information for follow-up counseling) 1SG Donalo has enrolled in an Associates degree program at University of Phoenix. The supply room received all GOs on the latest Command Inspection. Five of seven Ranger applicants successfully completed Ranger School exceeding the overall course completion rate of 40%. Current OPS TEMPO has prevented starting a Soldier of the Month board but the company does hold quarterly boards during the white cycle. The Brigade Command Sergeant Major recently commented on the quality of instruction and planning for the last company NCOPD and presented the NCO instructor with a brigade coin. Counselor: ______________________ Individual Counseled: ____________________ Date of Assessment:_________________
Note: Both the counselor and the individual counseled should retain a record of the counseling.

DA FORM 4856-E (Reverse)
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