DA Form 5376 Individual Training Evaluation Record

DA Form 5376 or the "Individual Training Evaluation Record" is a Department of the Army-issued form used by and within the United States Military.

The form - often incorrectly referred to as the DD form 5376 - was last revised on January 1, 2009. Download an up-to-date fillable DA Form 5376 down below in PDF-format or look it up on the Army Publishing Directorate website.

ADVERTISEMENT
NAME
CALENDAR YEAR
INDIVIDUAL TRAINING EVALUATION RECORD
For use of this form, see AR 420-1; the proponent agency is ACSIM
JAN
FEB
MAR
APR
MAY
JUN
JUL
AUG
SEP
OCT
NOV
DEC
L
TOTAL
I
SUBJ
TRAINING SUBJECTS
YEAR
Eval
Eval
Eval
Eval
Eval
Eval
Eval
Eval
Eval
Eval
Eval
Eval
N
FREQ
Hrs
Hrs
Hrs
Hrs
Hrs
Hrs
Hrs
Hrs
Hrs
Hrs
Hrs
Hrs
Gr
Gr
Gr
Gr
Gr
Gr
Gr
Gr
Gr
Gr
Gr
Gr
HRS
E
FIRE SUPPRESSION
PROFICIENCY TRAINING
1
AIRCRAFT EGRESS
Q
2
FIRST AID - CPR
Q
3
PUMPER OPERATIONS
A
4
RESCUE TOOLS
Q
5
TRAINING FIRES
SA
6
MUTUAL AID
A
7
STRUCTURAL DRILLS
M
8
PREFIRE PLANNING
Q
9
WATER SUP FOR FIRE PROT
Q
10
SPRINKLER SYSTEMS
Q
11
FIRE INSP PROCEDURES
SA
12
BREATHING APPARATUS
SA
13
APPARATUS TESTS
A
14
COMMUNICATIONS
SA
15
NATURAL COVER FIRES
Q
16
HAZARDOUS CML ACDT
Q
17
OTHER (List)
17A
17B
17C
17D
17E
17F
FIRE PREVENTION
PROFICIENCY TRAINING
18
INSPECTION PROCEDURES
SA
19
BUILDING CONSTRUCTION
SA
20
CLAS/OCCUPANCIES
SA
21
MEANS OF EGRESS
SA
22
FEATURES OF FIRE PROT
SA
23
BLDG SERVICE EQUIP
SA
DA FORM 5376, JAN 2009
PREVIOUS EDITIONS ARE OBSOLETE.
APD LC v1.00
NAME
CALENDAR YEAR
INDIVIDUAL TRAINING EVALUATION RECORD
For use of this form, see AR 420-1; the proponent agency is ACSIM
JAN
FEB
MAR
APR
MAY
JUN
JUL
AUG
SEP
OCT
NOV
DEC
L
TOTAL
I
SUBJ
TRAINING SUBJECTS
YEAR
Eval
Eval
Eval
Eval
Eval
Eval
Eval
Eval
Eval
Eval
Eval
Eval
N
FREQ
Hrs
Hrs
Hrs
Hrs
Hrs
Hrs
Hrs
Hrs
Hrs
Hrs
Hrs
Hrs
Gr
Gr
Gr
Gr
Gr
Gr
Gr
Gr
Gr
Gr
Gr
Gr
HRS
E
FIRE SUPPRESSION
PROFICIENCY TRAINING
1
AIRCRAFT EGRESS
Q
2
FIRST AID - CPR
Q
3
PUMPER OPERATIONS
A
4
RESCUE TOOLS
Q
5
TRAINING FIRES
SA
6
MUTUAL AID
A
7
STRUCTURAL DRILLS
M
8
PREFIRE PLANNING
Q
9
WATER SUP FOR FIRE PROT
Q
10
SPRINKLER SYSTEMS
Q
11
FIRE INSP PROCEDURES
SA
12
BREATHING APPARATUS
SA
13
APPARATUS TESTS
A
14
COMMUNICATIONS
SA
15
NATURAL COVER FIRES
Q
16
HAZARDOUS CML ACDT
Q
17
OTHER (List)
17A
17B
17C
17D
17E
17F
FIRE PREVENTION
PROFICIENCY TRAINING
18
INSPECTION PROCEDURES
SA
19
BUILDING CONSTRUCTION
SA
20
CLAS/OCCUPANCIES
SA
21
MEANS OF EGRESS
SA
22
FEATURES OF FIRE PROT
SA
23
BLDG SERVICE EQUIP
SA
DA FORM 5376, JAN 2009
PREVIOUS EDITIONS ARE OBSOLETE.
APD LC v1.00
JAN
FEB
MAR
APR
MAY
JUN
JUL
AUG
SEP
OCT
NOV
DEC
L
TOTAL
I
SUBJ
TRAINING SUBJECTS
YEAR
Eval
Eval
Eval
Eval
Eval
Eval
Eval
Eval
Eval
Eval
Eval
Eval
N
FREQ
Hrs
Hrs
Hrs
Hrs
Hrs
Hrs
Hrs
Hrs
Hrs
Hrs
Hrs
Hrs
Gr
Gr
Gr
Gr
Gr
Gr
Gr
Gr
Gr
Gr
Gr
Gr
HRS
E
24
PLACES OF
SA
PUBLIC ASSEMBLY
SA
25
EDUCATIONAL OCCUPANCIES
26
HEALTH CARE AND
SA
PENAL OCCUPANCIES
27
RESIDENTIAL OCCUPANCIES
SA
28
MERCANTILE OCCUPANCIES
SA
29
BUSINESS OCCUPANCIES
SA
30
INDUSTRIAL OCCUPANCIES
SA
31
STORAGE OCCUPANCIES
SA
32
OCCUPANCIES IN
SA
UNUSUAL STRUCTURES
33
OPERATING FEATURES
SA
34
FIRE EXTINGUISHERS
SA
35
FIRE ALARM SYSTEMS
SA
36
INSTALLED EXTINGUISHING
SA
SYSTEMS
37
INSTALLED SPRINKLER SYSTEMS
SA
38
PROJECT REVIEW/SUBMITTAL
SA
39
FIRE INVESTIGATION
SA
40
WELDING AND CUTTING
SA
41
MUNITIONS
SA
42
REPORTS/RECORDS
SA
43
BASE POPULATION TRAINING
SA
44
OTHER (List)
44A
44B
44C
44D
REMARKS
REVERSE OF DA FORM 5376, JAN 2009
APD LC v1.00
ADVERTISEMENT
Page of 2