DD Form 2496 International Student Academic Report

DD Form 2496 - also known as the "International Student Academic Report" - is a Military form issued and used by the United States Department of Defense.

The form - often incorrectly referred to as the DA form 2496 - was last revised on February 1, 1996. Download an up-to-date fillable DD Form 2496 down below in PDF-format or find it on the Department of Defense documentation website.

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INTERNATIONAL STUDENT ACADEMIC REPORT
(For International Military Students attending CONUS schools.)
(See AR 12-15, AFJI 16-105, and SECNAVINST 4950.4 for forms completion instructions.)
1.
FORWARDING
ADDRESS (Subsequent training, if applicable, or
2.
FROM
(Training installation preparing form)
country SAO)
3.
STUDENT NAME
4.
GRADE/RANK
5.
COUNTRY
6.
FMS CASE
OR IMET FY AND
(Last, First, Middle Initial)
WCN
7.
COURSE TITLE
8.
COURSE ID NO.
9.
COURSE MASL
10. DURATION OF COURSE
a.
FROM
(YYMMDD)
b.
TO
(YYMMDD)
12. STUDENT WAS AWARDED:
(X one)
11. DID STUDENT COMPLETE
13. ENGLISH COMPREHENSION LEVEL
COURSE?
(X one)
(Enter test score)
a.
DIPLOMA/CERTIFICATE
OF COMPLETION
a.
IN-COUNTRY
TEST
b.
CONUS
TEST
YES
b.
CERTIFICATE
OF ATTENDANCE
NO (Explain in Item 15)
c.
OTHER
(Explain in Item 15)
14. STUDENT'S ACADEMIC EVALUATION
b.
LANGUAGE
PROFICIENCY
c.
PERFORMANCE
IN CLASS
a.
RATINGS
SCALE (Enter in Items
14.b. and 14.c.)
(1) COMPREHENSION
ITEM
RATING
1
EXCEPTIONAL
(1) ATTITUDE AND MOTIVATION
2
EXCELLENT
(2) SPEAKING
(2) ATTENDANCE AND PUNCTUALITY
3
VERY SATISFACTORY
(3) ABILITY TO GRASP INSTRUCTION
4
SATISFACTORY
(3) READING
(4) PERFORMANCE IN PRACTICAL EXERCISES
5
UNSATISFACTORY
(5) PARTICIPATION IN CLASS ACTIVITIES
(Explain in Item 15)
(4) WRITING
(6) POTENTIAL AS INSTRUCTOR
6
NOT
OBSERVED
(If applicable)
(Explain in Item 15)
15. REMARKS ON ACADEMIC PERFORMANCE, AWARDS, AND OTHER INFORMATION
(Use back if more space is required)
16. REMARKS ON STUDENT'S PARTICIPATION IN EXTRACURRICULAR AND COMMUNITY AFFAIRS (On and off training installation)
(Use back if more space is required)
17. EVALUATOR
a.
NAME
(Last, First, Middle Initial)
b.
GRADE
c.
SIGNATURE
18. INTERNATIONAL MILITARY STUDENT OFFICER
a.
NAME
(Last, First, Middle Initial)
b.
GRADE
c.
SIGNATURE
DD FORM 2496, FEB 96
PREVIOUS EDITION IS OBSOLETE.
Adobe Professional 8.0
INTERNATIONAL STUDENT ACADEMIC REPORT
(For International Military Students attending CONUS schools.)
(See AR 12-15, AFJI 16-105, and SECNAVINST 4950.4 for forms completion instructions.)
1.
FORWARDING
ADDRESS (Subsequent training, if applicable, or
2.
FROM
(Training installation preparing form)
country SAO)
3.
STUDENT NAME
4.
GRADE/RANK
5.
COUNTRY
6.
FMS CASE
OR IMET FY AND
(Last, First, Middle Initial)
WCN
7.
COURSE TITLE
8.
COURSE ID NO.
9.
COURSE MASL
10. DURATION OF COURSE
a.
FROM
(YYMMDD)
b.
TO
(YYMMDD)
12. STUDENT WAS AWARDED:
(X one)
11. DID STUDENT COMPLETE
13. ENGLISH COMPREHENSION LEVEL
COURSE?
(X one)
(Enter test score)
a.
DIPLOMA/CERTIFICATE
OF COMPLETION
a.
IN-COUNTRY
TEST
b.
CONUS
TEST
YES
b.
CERTIFICATE
OF ATTENDANCE
NO (Explain in Item 15)
c.
OTHER
(Explain in Item 15)
14. STUDENT'S ACADEMIC EVALUATION
b.
LANGUAGE
PROFICIENCY
c.
PERFORMANCE
IN CLASS
a.
RATINGS
SCALE (Enter in Items
14.b. and 14.c.)
(1) COMPREHENSION
ITEM
RATING
1
EXCEPTIONAL
(1) ATTITUDE AND MOTIVATION
2
EXCELLENT
(2) SPEAKING
(2) ATTENDANCE AND PUNCTUALITY
3
VERY SATISFACTORY
(3) ABILITY TO GRASP INSTRUCTION
4
SATISFACTORY
(3) READING
(4) PERFORMANCE IN PRACTICAL EXERCISES
5
UNSATISFACTORY
(5) PARTICIPATION IN CLASS ACTIVITIES
(Explain in Item 15)
(4) WRITING
(6) POTENTIAL AS INSTRUCTOR
6
NOT
OBSERVED
(If applicable)
(Explain in Item 15)
15. REMARKS ON ACADEMIC PERFORMANCE, AWARDS, AND OTHER INFORMATION
(Use back if more space is required)
16. REMARKS ON STUDENT'S PARTICIPATION IN EXTRACURRICULAR AND COMMUNITY AFFAIRS (On and off training installation)
(Use back if more space is required)
17. EVALUATOR
a.
NAME
(Last, First, Middle Initial)
b.
GRADE
c.
SIGNATURE
18. INTERNATIONAL MILITARY STUDENT OFFICER
a.
NAME
(Last, First, Middle Initial)
b.
GRADE
c.
SIGNATURE
DD FORM 2496, FEB 96
PREVIOUS EDITION IS OBSOLETE.
Adobe Professional 8.0
15. REMARKS ON ACADEMIC PERFORMANCE, AWARDS, AND OTHER INFORMATION (Continued)
16. REMARKS ON STUDENT'S PARTICIPATION IN EXTRACURRICULAR AND COMMUNITY AFFAIRS (On and off training installation)
(Continued)
LEGEND (Explanation of Acronyms)
CONUS - Continental United States
MASL - Military Articles and Services List
FMS
- Foreign Military Sales
SAO - Security Assistance Organization
ID NO. - Identification Number
WCN - Worksheet Control Number
IMET
- International Military Education and Training
DD FORM 2496 (BACK), FEB 96
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