Form NSTC 1533 NSTC 1533 Applicant Interview Form

Application Forms Booklet, Naval Reserve Officers Training Corps Scholarship Program

NSTC 1533_157 (07-16) Applicant Interview Form

Application Forms Booklet, Naval Reserve Officers Training Corps Scholarship Program

OMB: 0703-0026

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Appendix A
NROTC Officer Interview (OI) Form

Applicant’s Name: ____________________________
Date: _____________________
Name of Interviewer: First: ____________________ MI:_________ Last:______________________
Approximate number of NROTC interviews conducted: This cycle: _________

Total:_______

Phone number of Interviewer: __________________
Designator: _____________

Rate/Rank: ___________

Unit: __________

I have reviewed the Officer Interview reference guide: ___________ (initials)
Prior to conducting the interview, review the candidate’s application and comment on any discrepancies
found that may be relevant to the Scholarship Selection Board. Ask the applicant to clarify and explain
any inconsistencies in the application form.
Comments:

NSTC 1533/157 (07-16)

1

OMB Control Number: 0703-0026, Exp _______________
AGENCY DISCLOSURE STATEMENT
The public reporting burden for this collection of information is estimated to average 3 hours and 30 minutes 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 the Department of Defense, Washington Headquarters Services, Executive Services Directorate,
Directives Division, 4800 Mark Center Drive, East Tower, Suite 02G09, Alexandria, VA 22350-3100 (OMB Control Number: 0703-0026).
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 RESPONSE TO THE ABOVE ADDRESS.
Responses should be sent to:
Commander
Naval Service Training Command
2601 A Paul Jones Street
Great Lakes, IL 60088
PLEASE READ THE FOLLOWING STATEMENT REQUIRED BY THE PRIVACY ACT OF 1974 BEFORE COMPLETING THE
APPLICATION.
1.AUTHORITY: The authority to request this information is contained in: 5 U.S.C. § 301 (Authorizing Departmental Forms and Regulations); 10
U.S.C. § 2107 (Financial Assistance Program); and Executive Order 9397 (Use of Social Security Numbers).
2.PRINCIPAL PURPOSE(S): The information you provide will be used to determine whether you qualify, and should be nominated for, an
NROTC Scholarship. If you are nominated, the information will be used to enroll you into NROTC and will be used by the Navy in its
management of the NROTC program. The following systems of records notices cover the collection of this information: N01130-1 located at
http://dpcld.defense.gov/Privacy/SORNsIndex/DODwideSORNArticleView/tabid/6797/Article/570316/n01130-1.aspx.
3.ROUTINE USE(S): Information provided on the application will be used to screen and select individuals to received NROTC Scholarships, to
maintain data on the NROTC scholarship program, to compare to scholarship applicants from previous or subsequent years, and to provide
academic data and contact information to Navy activities and admissions officials at colleges and universities so they can contact applicants for
recruitment purposes. Other uses may include providing the information to officials and employees of: the Department of Transportation; other
agencies of the Executive Branch upon request in relation to the management of quality of military recruitment; and the Department of Veterans
Affairs and Selective Service Administration in relation to enlistment or reenlistment eligibility. Information you provide in this application is
protected by the Privacy Act and will not be released outside of the Department of Defense without your permission unless it comes with an
exception to the Act or one of the routine uses in 32 C.F.R. § 701.112, http://www.privacy.navy.mil/ and the routine uses set forth here. If you are
nominated for an NROTC Scholarship, the information will be released to the top five schools you indicated on your application. Your
information and notification of status may also be provided to your high school so they may assist with the final stages of the process.
4.DISCLOSURE: The social security number (SSN) is required at the time of application to ensure proper identification of the applicants. There
are times applicants have the same names, therefore the SSN is required to ensure proper identification. Providing the requested information is
voluntary. However, failure to do so may result in our inability to process your application for the NROTC program.

NSTC 1533/157 (07-16)

Instructions
The performance competencies that are included below have been vetted through Naval Officer
SME’s using an iterative process. The focus was to identify areas that are known to contribute
significantly to success as an NROTC midshipman and as a Naval Officer.
Please keep in mind that when evaluating the candidate on each performance competency that it
is important to separate information gathered from other items or general impressions from the
information obtained solely for the competency in question. In other words, when rating
Propensity to Serve (the first performance competency) use only information collected during the
response to that question to evaluate the candidate’s Propensity to Serve. Performance
competencies include: a) Propensity to Serve, b) Embracing a Healthy Lifestyle,
c) Communication, d) Teamwork/Interpersonal Relations, and e) Judgment/Decision-making.
A final category, Overall Suitability, is included to provide the interview’s assessment of the
candidate’s likelihood of performing successfully as an undergraduate NROTC midshipman and
a future Naval Officer. The judgment for rating this category should be based on all of the
information available to the interviewer as a result of the interview process. Utilize the
information gathered and the ratings provided for the individual performance competencies to
inform the Overall Suitability rating; however do not simply use the arithmetic average of these
categories.

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Performance Competency 1: Propensity to Serve
Definition:
Short term competency: NROTC program motivation
Long term competency: Naval Officer
Strong desire to serve in the Navy (including NROTC unit), embraces obligation to serve the country,
realistic understanding of military service and has definite interest in considering a Naval career.
Lead Questions:
Q1: Provide examples of activities in which you have been involved that have developed your desire or
ability to serve in the military.
Q2: If you receive an NROTC scholarship, what warfare specialty or mission area are you interested in
pursuing, and why? What would you do if you are assigned to a community that is not your preference?
Q3: If for some reason you were not selected for the NROTC scholarship, what is your backup plan?
Explain your thought process?
Below Expectations
• Only wants to serve in one
specific community.
• Not willing to consider other
paths to commission
• Self-serving motivation for
the scholarship.
• Only wants a commission if it
fits their plan.
• Concerned with what the
Navy can do for them and not
vice versa.
1

2

Low
Specific Reasons for Ratings:

NSTC 1533/157 (07-16)

Meets Expectations
• Passionate about a specific
community however, would
consider alternate paths to
commission.
• Only willing to serve in some
communities but not others.
• Under appropriate
circumstances, willing to
subordinate personal interests.

3

Mid Range

Exceeds Expectations
• Passionate about a specific
community however, has a
willingness to pursue alternate
paths to a commission.
• Willing to serve where
needed.
• Applying for a NROTC
scholarship for the purpose of
serving country.

4

5

High

3

Performance Competency 2: Embracing a Healthy Lifestyle
__________________________________________________________________________________
Definition:
Adopts a culture of physical fitness, healthy nutritional habits, and mental well-being.
Lead Questions:
Q1: Other than organized varsity, intramural or club sports, describe how you maintain and improve you
physical fitness. Do you have a regular physical fitness routine? Why or why not is physical fitness a
priority for you?
Q2: Tell me about your diet and how it relates to your current physical fitness level.
Q3: Can you describe a very stressful event in your life, how you dealt with it, and what you learned
about yourself that could help you in a similar situation in the future?
Below Expectations
• Does not participate in
regular physical activity.
• Healthy eating is not a
priority.
• Does not have methods for
dealing with stress.
• Does not engage in physical
activity.

1

2

Low
Specific Reasons for Ratings:

NSTC 1533/157 (07-16)

Meets Expectations

Exceeds Expectations

• Engages in physical activities
infrequently.
• Tries to eat healthy meals
when convenient.
• Is able to deal with stress
sometimes but not others.
• Is involved in school sports but
strictly motivated by coach.

• Regularly participates in
physical activity.
• Strictly abides to healthy
diet.
• Has methods for dealing
with stress that provide
positive outcomes.
• Involved in many aspects of
daily/weekly physical activities
that are not formal high
school sports.

3

Mid Range

4

5

High

4

Performance Competency 3: Communications
__________________________________________________________________________________
Definition:
Conveys information clearly and effectively, demonstrates active listening skills, and response to
questions indicates active participation in the conversation.
Lead Questions:
Q1: Can you tell me about a time when miscommunication caused a problem for you, how you fixed the
issue, and what you learned from the experience?
Q2: We have all met people that we would describe as “poor communicators.” Of those people you
have met that fall into this category, can you describe several of their characteristics that made them
“poor communicators” in your opinion?
Q3: If someone had a problem and wanted to talk to you about it, what would you do to demonstrate
that you are receptive and actively engaged in the conversation?
Below Expectations

Meets Expectations

Exceeds Expectations

• Does not understand that
miscommunication can cause
problems.
• Unable to effectively answer
questions.
• Inability to organize thoughts
and answer questions directly.

• Understands that
miscommunication can cause
problems.
• Able to communicate
adequately.
• Able to organize thoughts and
respond to questions.

• Engages in effective
communication skills which
involve active listening,
engagement, and interaction.
• Able to communicate
specific details and examples,
elaborate well, and provide a
mature response.
• Strong ability to organize
thoughts and respond
thoughtfully.

1

2

Low
Specific Reasons for Ratings:

NSTC 1533/157 (07-16)

3

Mid Range

4

5

High

5

Performance Competency 4: Teamwork/ Interpersonal Relations
__________________________________________________________________________________
Definition:
How the individual functions in a group setting, putting the group’s goals ahead of one’s personal goals,
and ability to assume different roles (leader versus follower) depending on the context.
Lead Questions:
Q1: Describe a situation in your life in which you were placed in a leadership position on short notice.
How did you handle leading the group? What challenges did you face and what did this experience
teach you?
Q2: Describe how you have been an effective follower in a group setting, and how that impacted your
role as a leader?
Q3: Give me an example of when you have been asked to sacrifice your personal success and
gratification in order to serve a larger group or organizational goal. Why did you make the choice you
did? What were the results or consequences of your decision?
Below Expectations

Meets Expectations

Exceeds Expectations

• Reluctance to lead, follow, or
do both if required.
• Puts self before the team.
• Always valuing self over
others.

• Indicates willingness to lead,
follow, or do both if required.
• Willing to be a part of a team.
• In instances where there is
group consensus, demonstrates
a tendency to agree with group
goals.

• Is proactive and willing to
lead, follow, or do both if
required.
• Always considers team's
needs before self.
• Willing to sacrifice individual
success to achieve group
goals.

1

2

Low
Specific Reasons for Ratings:

3

Mid Range

4

5

High

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6

__________________________________________________________________________________
Performance Competency 5: Judgment/ Decision-making
__________________________________________________________________________________
Definition:
Approach used to work through problems, weighing potential courses of action and considering
potential solutions and consequences, and ability to make a decision.
__________________________________________________________________________________
Lead Questions:
Q1: Can you tell us about a situation when you had to make a difficult decision or judgment call, what
considerations you made, and what that taught you about your ability to make decisions?
Q2: Describe a situation in which you had to make a challenging decision that negatively impacted
another person or group. What was the basis of your decision, and describe in detail how you
formulated and evaluated the pros and cons of the impacts of the decision? Do you still believe you
made the right decision, and describe why or why not?
Below Expectations
• Uncomfortable to seek help
in making decisions, even in
situations where it would be
beneficial.
• Makes impacting decisions on
scant or irrelevant information.
• Makes decisions without
considering the consequences.

1

2

Low
Specific Reasons for Ratings:

NSTC 1533/157 (07-16)

Meets Expectations
• Will seek help if required.
• Uses information only if it's
readily available.
• Does not consider all the
consequences before making a
decision.

3

Mid Range

Exceeds Expectations
• Comfortable seeking help in
making decisions.
• Uses as much information as
possible before making
decision.
• Indicates a willingness to
accept the known (and
unanticipated) consequences
of taking actions or making a
decision.
4

5

High

7

Overall Suitability
__________________________________________________________________________________
Assess the candidate’s suitability for the NROTC program and potential as a Naval Officer.
Rate this category based on overall impressions of the interview. DO NOT simply take the average of the
other performance categories.

Do Not Recommend
• Does not meet
program minimum
requirements
• Do not recommend for
NROTC scholarship
• Of all applicants
interviewed BOTTOM
25%

Recommend
• Has potential to be a
successful midshipman
• Consider for NROTC
scholarship
• Of all applicants
interviewed AVERAGE
50%

Strongly Recommend
• Has potential to be a
successful
midshipman and
officer
•Strongly recommend
for NROTC scholarship
• Of all applicants
interviewed TOP 40%

Highest
Recommendation
• Great potential to
excel as midshipman
and officer
• Has highest
recommendation to
receive NROTC
scholarship
• Of all applicants
interviewed TOP 25%

Specific Reasons for Ratings:

NSTC 1533/157 (07-16)

8

Other: Comment on any other relevant topics of interest to the NROTC Selection Board, particularly
anything that makes this candidate’s situation/application different or stand out from other applicants. If
none, enter N/A.
Comments:

NSTC 1533/157 (07-16)

9


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