DD Form x559 Detailed Skilled Self-Assessment

FOR NLSC USE ONLY
CONTROL NUMBER

NATIONAL LANGUAGE SERVICE CORPS (NLSC) PILOT
DETAILED SKILLS SELF-ASSESSMENT
PRIVACY ACT STATEMENT

AUTHORITY: 5 U.S.C. 301, Departmental Regulations; 10 U.S.C. 131, Office of the Secretary of Defense; DoD Directive 5124.2, Under Secretary of Defense for Personnel and
Readiness; 50 U.S.C. 403-1b, War and National Defense; Public Law 109-364, Sec. 944, Administration of Pilot Project on Civilian Linguist Reserve Corps; and Public Law
108-487, Sec. 613, Pilot Project on Civilian Linguist Reserve Corps. The OSD System of Records Notice name and number for this collection is National Language Service Corps
Pilot Records, DHRA 07.
PRINCIPAL PURPOSE(S): To allow U.S. citizens aged 18 years and older with language and special skills to self-identify these skills by completing NLSC Self Assessments as
an initial indicator of language proficiency. Those selected for activation and deployment will be officially tested to validate NLSC Self Assessment skills. The information collected
will be used to identify and contact NLSC Charter Members and prospective Charter Members in times of need. The collection will allow preliminary background checks prior to
any final appointment in the NLSC of only those individuals the NLSC expects to employ temporarily during the Pilot program. Background checks are not expected for the
remaining Charter Members.
ROUTINE USE(S): To Federal Government agencies requesting language support to facilitate U.S. efforts on the war on terrorism or in furtherance of national security objectives.
The DoD "Blanket Routine Uses" set forth at the beginning of OSD's compilation of systems of records notices apply to this system.
DISCLOSURE: Voluntary. However, failure to provide information may result in non-enrollment in the NLSC Pilot, and refusal to grant access to Charter Member areas of the
NLSC Pilot Internet portal.

SECTION I - ASSESSMENT: LISTENING PROFICIENCY IN
(Language)
(X one) YES NO

1. I can understand someone ordering food and something to
drink in a restaurant.
2. I can understand a store clerk telling me how much a shirt
costs, and then telling me what different colors and sizes are
available.
3. I can understand if a friend introduces me to a co-worker we
happened to meet in a public place.
4. If I call a bank on the phone I can comprehend when they
tell me their schedule and their business hours the next day.
5. I can comprehend what is said to me if I call a doctor's office
to verify the date and time for an appointment.
6. I can comprehend what friends say to me about the kinds of
things they like to do when they are not working.
7. I can understand someone who tells me how many brothers
and sisters they have, what their ages are, and where they live.
8. I can understand my friend on the phone when he or she
tells me some interesting things to do on the weekend.
9. I can understand my friend if he or she calls me and describes
in detail the house or apartment in which they are staying.
10. I can understand a friend's story about what happened to
him or her on their last vacation.
11. I can understand an employee who tells me in detail what
they did earlier in the day or what they plan to do after
leaving work.
12. I can understand someone who is interviewing for a job and
describes in detail the main responsibilities that they had on
a previous job.
13. I can understand my friend telling me what he or she will do
on the weekend.
14. I can understand someone who compares and contrasts
two towns or cities they have lived in or visited.
15. I can understand someone who compares and contrasts the
appearances of two members of their family.
16. I can understand when someone tells me about their
physical ailments.
17. I can understand someone who tells me the details of the
longest trip they ever took.
18. I can understand a professor who describes the educational
system in another country and contrasts it with the
educational system in the U.S.
19. I can understand someone who states their opinion on the
topic of adopting children from other countries and supports
their views with examples and explanations.
20. I can understand someone who explains the process of a
"fair trial" in the judicial system of their country.
21. I can understand my boss telling me about a problem involving
two co-workers who are not getting along, offering a suggestion
to resolve the situation, and providing reasons for why he or
she thinks the solution will be effective.
22. I can follow a sustained conversation with friends about
current events that I hear about on the news or read about
on the internet.
23. I can understand co-workers at a meeting explaining or
discussing a project they are working on.
24. I can comprehend a presentation to students at a local
college on the merits of employment in my profession.

(X one) YES NO

25. I can comprehend a talk to a group of parents in my
community about the merits of parental supervision and
attempting to persuade them to encourage their children to
be careful and act responsibly.
26. I can comprehend a talk to a group of parents in my community about the merits of a summer internship program with a
company and attempting to persuade them to encourage their
children to participate in the program rather than enrolling them
tn a summer academic program that provides college credit.
27. I can understand national and international news on the radio
or on television.
28. I can comprehend what is said to me when I call the public
health department and complain about unsanitary conditions
that I have witnessed in some of the area's restaurants. I can
understand what is said when they tell me about their inspection policies and what they will do to investigate my claims in
the immediate future.
29. I can easily follow a sustained, heated discussion with my
neighbors about revising the criteria by which teachers are
evaluated for promotion at a local school.
30. I can comprehend an oral presentation at a conference on a
complex topic in my profession, and I can also comprehend
the question-and-answer session immediately following the
main part of the talk.
31. I can follow easily someone who decides to explain all
aspects of their professional work to me.
32. I can comprehend almost everything that is said in formal
situations on a wide range of topics.
33. I can follow a 2-hour training session for new employees
requiring me to comprehend concepts and materials that are
highly specialized within my profession.
34. I can comprehend everything in representing my company with
a co-worker at a meeting during which the company's policies
for hiring and laying off workers are being challenged by
community members and local government officials.
35. I can comprehend a speech at a fundraising event for cancer
research. I can evaluate how effectively the speaker addresses
the audience, reasserts the importance of this research for
everyone involved, and relates a personal story about cancer
in his or her own family.
36. My broad vocabulary and cultural background allows me to
understand anything said from sports broadcasts to college
lectures to public speeches by political figures, so long as I
have some knowledge of the topic.
37. I can understand complex speech, such as a well-rehearsed
and profound sermon, a lecture on a philosophical topic, or
a heated political debate.
38. I can comprehend with ease everything said at a meeting with
community leaders and parents aimed at creating both
recreational activities and summer employment opportunities
for local youths. The speaker greets the audience members,
introduces himself/herself eloquently, and then reviews
problems the community has been having with kids in summers
past when area schools were not in session, and introduces
the planned initiatives.
39. I can understand formal speech and informal speech,
including slang, dialect, cursing and jokes with double
meanings.
40. I can understand all forms of speech as well as a highly
educated native speaker of the language.
Page 1 of 4 Pages

D R A F T

DD FORM 2933 TEST, 20090108 DRAFT

Adobe Professional 8.0

FOR NLSC USE ONLY
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NATIONAL LANGUAGE SERVICE CORPS (NLSC) PILOT
DETAILED SKILLS SELF-ASSESSMENT
SECTION II - ASSESSMENT: SPEAKING PROFICIENCY IN
(Language)
(X one) YES NO

1. I can tell/ask someone how to get from here to the nearest
hotel, restaurant, or post office.
2. I can order a simple meal.

(X one) YES NO

27. I can speak to a group of educated native speakers on a
professional subject and be sure I am communicating what
I want to, without my language skills amusing or irritating
them.

4. I can buy a needed item of clothing or a bus or train ticket.

28. I can listen, take notes, and summarize accurately a speech
or an informal discussion in my area of special interest,
heard on the radio or over a public address system.

5. I can understand and respond correctly to standard
questions about my nationality, marital status, occupation,
date and place of birth, etc.

29. I can (on a social occasion) defend U.S. attitudes toward
culture, race relations, and foreign aid, from attack by an
anti-American student or politician.

6. I can introduce myself appropriately.

30. I can cope with such trying linguistic situations as brokendown plumbing, an undeserved traffic ticket, or a serious
social or diplomatic blunder made by myself or a colleague.

3. I can negotiate for a hotel room or a taxi ride at a fair price.

7. I can take leave in a social situation (someone's house, an
office, a conversation) appropriately.
8. I can use the language well enough to assist someone who
does not know the language in coping with the situations or
problems covered in the previous statements.
9. I can describe my present or most recent job in some detail.
10. I can give detailed information about my family, my house,
the weather today.

31. I can follow connected discourse on a non-technical subject,
e.g., a panel discussion on the status of women.
32. I feel that I have a professional command (rather than just a
practical one) of the language.
33. I can use the language to speculate at length about how
some change in history or the course of human events would
have affected my life or civilization, e.g., how our lives would
be different without the invention of the computer.

D R A F T

11. I can hire an employee, or arrange for special services
taking care of details such as salary, qualifications, hours,
specific duties.

12. I can give a brief autobiography and tell of immediate plans
and hopes.
13. I can describe the basic structure of the U.S. Government or
of the U.S. educational system.

34. In professional discussion, my vocabulary is always
extensive and precise enough to enable me to convey my
exact meaning.
35. I am able to alter my speech deliberately, depending upon
whether I am talking to university professors, supervisors,
subordinates, elders, close friends, employers, etc.

14. I can describe the purpose or function of the organization
I represent.

36. I can serve as an informal interpreter for a U.S. senator or
cabinet official on all diplomatic and social functions.

15. I can understand what native speakers want to tell me on
topics like those mentioned above, and they understand me
(linguistically) at least 80% of the time.

37. I practically never make a grammatical mistake.
38. I think I can carry out any job assignment as effectively in
the language as in my native language.

16. I can take and give simple messages over the telephone.
17. I can describe the geography of the U.S. or a familiar
location.
18. I can describe in detail a person or place that is very familiar
to me.

39. I can use the language sufficiently and effectively to
convince a good friend to give up habits or behaviors that
hurt them, such as smoking, overeating, etc.

19. I can discuss the parts of the body and general ailments
afflicting them.

40. I can use the language sufficiently well to act as an
interpreter for a high-ranking U.S. Government official
making a state visit to the country where the language is
spoken.

20. I can tell the facts of what has been reported recently on
television news or in the newspaper.

41. Educated native speakers react to me as they do to each
other.

21. I can tell about a trip I took or some other everyday event
that happened in the recent past.

42. I sometimes feel more at home in this language than in
my native language.

22. I can use the language well enough to assist someone else,
who does not know the language, in coping with the
situations or problems covered in statements 9 - 21.

43. I can do mental arithmentic in the language without slowing
down.

23. There are no grammatical features of the language that I try
to avoid.
24. I never find myself in the middle of a sentence I cannot
finish because of linguistic limitations (grammar or
vocabulary).
25. I do not find it difficult to follow and contribute to a
conversation among native speakers who try to include me.
26. I am never afraid that I will misunderstand information given
to me over the telephone.

DD FORM 2933 TEST, 20090108 DRAFT

44. My vocabulary is at least as extensive and precise as in
my native language.
45. I consider myself a well educated native speaker of the
language.
46. I have a broad grasp of the idioms, colloquialisms, and
cultural references used in the language.
47. In discussions on all subjects, my vocabulary is always
extensive and precise, allowing me to convey my exact
meaning.
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FOR NLSC USE ONLY
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NATIONAL LANGUAGE SERVICE CORPS (NLSC) PILOT
DETAILED SKILLS SELF-ASSESSMENT
SECTION III - ASSESSMENT: READING PROFICIENCY IN
(Language)
(X one) YES NO

(X one) YES NO

19. I can read difficult material, such as technical material in
other specialties, complex opinion/editorial pieces, or
literature, with occasional use of a dictionary.

1. I can recognize names of people and places.

2. I can read street signs well enough to find my way.

3. I can recognize common words for shops and businesses.

20. I can serve as an informal translator of newspapers,
correspondence, and technical material in my field.
21. I can read and understand precise instructions and
explanations sent in this language by professional
associates via email.

4. I can read posted prices.

5. I can read a weather report.

22. I feel that I have a professional knowledge (rather than just
a practical one) of the language.

6. I can read want-ads, well enough to locate, for example, an
apartment.
7. I can read the language well enough to assist someone who
does not know the language in coping with the above
situations.

23. In my professional reading, my vocabulary and cultural
background are always extensive and precise enough to
allow me to understand the exact meaning, even if it is not
explicitly stated.

24. I am able to follow a wide variety of writing styles, including
academic, formal professional, poetry, colloquial, and slang.

D R A F T

8. I can read news items about frequently occurring events.

9. I can read and follow simple biographical information.

25. I can understand writing that includes the use of a regional
dialect of the language, possibly with some assistance from
a dictionary or native speaker.

10. I can read social notices (such as wedding
announcements).
11. I can read business letters in a standard format on common
topics.
12. I can read simple technical material written for the general
reader.

13. I can read and get the main points of technical material
written for specialists in my field.

14. I can read and understand nearly all email sent by friends
and family in this language.

15. I can use the language well enough to assist someone else
who does not know the language in coping with the
situations or problems covered by statements 8 - 14.

16. I can read standard newspaper items addressed to the
general reader (including feature items).

26. I can serve as an informal translator of high-stakes
materials that might, for example, affect national security.

27. I can carry out any job assignment involving reading as
effectively in this language as in my native language.

28. In my reading on all subjects, my vocabulary and cultural
background are always extensive and precise enough to
enable me to understand the exact meaning, whether or
not it is explicitly stated.

29. I can read everything in this language as well as I can in
my native language.

30. I can do mental arithmetic in the language without slowing
down.

31. My reading vocabulary is at least as extensive and precise
as that of a highly educated monolingual native speaker of
the language.

17. I can read routine articles in print or on the Web.

18. I can read and understand nearly everything in technical
reports and printed material in my field.

DD FORM 2933 TEST, 20090108 DRAFT

32. I consider myself as competent as any native reader of the
language.
Page 3 of 4 Pages

FOR NLSC USE ONLY
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NATIONAL LANGUAGE SERVICE CORPS (NLSC) PILOT
DETAILED SKILLS SELF-ASSESSMENT
SECTION IV - ASSESSMENT: WRITING PROFICIENCY IN
(Language)
(X one) YES NO

1. I can send a short email (or text message or letter) to a
friend to invite them to have lunch with me.
2. I can write down a summary of a phone message from my
friend that contains directions on how to get to his or her
apartment.
3. I can leave a note for someone saying that I had to leave to
go to a doctor's appointment, and say when I expect to
return.
4. I can write a note or email message to my co-worker to
explain that I am not feeling well and will not be at work the
next day.
5. I can write a letter or email message to a new friend telling
him or her several types of things I like to do in my spare
time.
6. I can write a simple invitation that tells my friends when and
where my party will be held.

(X one) YES NO

25. I can write a newsletter article on the merits of study abroad
for parents in my community and persuade them to
encourage their children to participate in study-abroad
programs despite the fact that they have concerns about the
high cost of such programs and worries about safety and
security.
26. I can write a newsletter article for my community about the
merits of a summer internship program that several area
companies are participating in. I can persuade them in the
article to encourage their children to participate in the
program rather than enrolling them in a summer academic
program that provides college credit.
27. I can write a letter of recommendation for a colleague.
28. I can write a letter to the Department of Health to complain
about unsanitary conditions that I have witnessed in some
of the area's restaurants. I can ask them about their
inspection policies and persuade them to investigate my
claim in the immediate future.

7. I can prepare a classified advertisement that describes the
kind of apartment I want to rent.

29. I can write an extended editorial piece for the local newspaper that deals with a proposal to revise the criteria by
which teachers are evaluated for promotion at a local school.

8. I can send an email to my friend that describes in
paragraphs the house or apartment that I am staying in.

30. I can write a paper on a complex topic in my profession that
I have been working on for several weeks or months, and
the quality of this paper would be adequate for publication
in a national journal.

9. I can write a letter or email message to a friend that tells a
story about what happened to me on my last vacation.

31. I can write a letter to my supervisor explaining all aspects of
my professional work for the purpose of negotiating a raise.
The letter would present a detailed and convincing argument
for allotting more responsibilities to me and granting me a
promotion.

D R A F T

10. I can write a note for my supervisor that tells what I did
earlier in the day and what I plan to do before I leave.

11. I can write a letter to my friend to tell him or her what I will
do on my next vacation.
12. I can write an essay that compares two towns or cities that
I have lived in or visited.
13. I can write an essay that compares the personalities of two
members of my family.
14. I can write the parts of the body, and general ailments
afflicting them.
15. I can write a description of a person's physical
characteristics and description.
16. I can write a story that recounts the details of a trip I took.
17. I can write a note that explains how a first aid procedure
works (conceptually) or will be conducted (procedurally).

32. I can write training materials for new employees in which I
would explain concepts and materials that are important
within my profession.
33. I can write an article aimed at students at a local college on
the merits of employment in my profession. I can write
about a career path in my profession that starts with
obtaining a high-quality and appropriate education, followed
by internships and an entry-level position, and then
progressing with promotions and various opportunities for
advancement that are based on good decision making and
solid performance.
34. I can write an extended letter to the editor or press release
defending my company after a recent meeting during which
some of the company's policies for hiring and laying off
workers have been challenged by community members and
local government officials.

19. I can write a paper that describes the educational system in
the United States and contrasts it with the educational
system in another country.

35. I can prepare an effective statement of support to be
distributed at a fundraising event for cancer research. I can
appropriately outline the priority issues in a sensitive way,
reassert the importance of this research for everyone
involved, and effectively relate a personal story about
cancer in my own family.

20. I can write an editorial for a newspaper stating my opinion
on the topic of adopting children from other countries and
support my views with examples and explanations.

36. I can write an article or essay on a non-professional topic
that interests me, reviewing and analyzing the issues;
proposing and evaluating at least two solutions; and arguing
why a particular solution is best.

18. I can write a cover letter for a job application that describes
in detail the responsibilities I had on my previous job.

21. I can write an essay that explains the process of a "fair trial"
in the U.S. judicial system.
22. I can write a memo to my boss discussing a problem a
company is facing, offer a solution to the situation, and
provide reasons for why I think my solution will be effective.
23. I can write letters to a friend that discuss in detail current
concerns that I hear about on the news or read about on
the internet.
24. I can write a detailed memo to my boss to explain why a
project that I am managing is behind schedule and convince
him that I have a plan that will allow me to meet the project's
final deadline.

DD FORM 2933 TEST, 20090108 DRAFT

37. I can write a highly literate proposal for distribution and
discussion at a meeting of community leaders and parents
aimed at creating both recreational activities and summer
employment opportunities for local youths. The proposal
would respectfully acknowledge all of the stakeholders,
review problems the community has been having with kids
in summers when area schools were not in session, and
introduce the planned initiatives.
38. In my writing, I can use the language with complete flexibility
and intuition so that it is fully accepted by well-educated
native speakers in all of its features, including breadth of
vocabulary and idioms, colloquialisms, as well as relevant
cultural and historical references.

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