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pdfCUI (when filled in)
NATIONAL LANGUAGE SERVICE CORPS (NLSC)
DETAILED SKILLS SELF-ASSESSMENT
FOR NLSC USE ONLY
CONTROL NUMBER
OMB No. 0704-0449
OMB approval expires
XX/XX/XXXX
PLEASE RETURN YOUR COMPLETED FORM TO:
NATIONAL LANGUAGE SERVICE CORPS, P.O. BOX 12221, ARLINGTON, VA 22219-2221
The public reporting burden for this collection of information is estimated to average 12 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, at [email protected]. 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.
PRIVACY ACT STATEMENT
AUTHORITY: 10 U.S.C. 131, Office of the Secretary of Defense; 50 U.S.C. 1913, National Language Service Corps; and DoD Directive 5124.02, Under
Secretary of Defense for Personnel and Readiness (USD(P&R)).
PRINCIPAL PURPOSE(S): To allow U.S. citizens with language skills to self-identify their skills for the purpose of temporary employment on an intermittent work
schedule or service opportunities in support of DoD or another department or agency of the United States. The information will be used to determine applicants'
eligibility for NLSC membership and to identify and contact NLSC members.
ROUTINE USE(S): Disclosure of records are generally permitted under 5 U.S.C. 522a(b) of the Privacy Act of 1974, as amended. To another department or
agency of the United States in need of temporary short-term foreign language services, where government employees are required or desired. Additional routine
uses are listed in the applicable System of Records Notice, DHRA 07, National Language Service Corps (NLSC) Records at: https://dpcld.defense.gov/
Portals/49/Documents/Privacy/SORNs/OSDJS/DHRA-07.pdf
DISCLOSURE: Voluntary; however, failure to provide information may result in non-enrollment in the NLSC and refusal to grant access to member areas of the
NLSC portal.
SECTION 1 - READING.
LANGUAGE:
INSTRUCTIONS: The following Self-Assessment of foreign language Reading Proficiency is intended to serve as a rough estimate of foreign language proficiency. It is not necessary
to know all the words or understand all the details of the texts listed for each item number below, but it is necessary in order to perform the functional tasks described at the indicated
level of accuracy. To estimate your level of proficiency, please read each task statement below and check “yes” if you believe you can perform the stated task and “no” if you do not
believe you can perform it. If a statement describes your ability only some of the time, or only in some contexts, you should answer “no”.
(X one)
YES
(X one)
NO
1. I can recognize names of people and places.
17. I can read routine articles in print or on the Web.
2. I can read street signs well enough to find my way.
18. I can read and understand nearly everything in technical
reports and printed material in my field.
YES
NO
NEEDS DD67
4. I can read posted prices.
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.
5. I can read a weather report.
20. I can serve as an informal translator of newspapers,
correspondence, and technical material in my field.
6. I can read want-ads, well enough to locate, for example,
an apartment.
21. I can read and understand precise instructions and
explanations sent in this language by professional
associates via email.
3. I can recognize common words for shops and businesses.
7. I can read the language well enough to assist someone
who does not know the language in handling the above
situations.
8. I can read news items about frequently occurring events.
9. I can read and follow simple biographical information.
10. I can read social notices (such as wedding
announcements).
11. I can read business letters on common topics written in a
standard format.
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 read the language well enough to assist someone
else who does not know the language in coping with the
situations covered by statements 8-14.
16. I can read standard newspaper items addressed to the
general reader (including feature items).
DD FORM 2933, 20210622 DRAFT
PREVIOUS EDITION IS OBSOLETE.
22. I have a level of skill in reading this language that allows
me to fulfill my professional obligations.
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.
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.
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 in this
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.
30. My reading vocabulary is at least as extensive and precise
as that of a highly educated monolingual native speaker of
the language.
31. I consider myself as a competent reader of the language.
CUI (when filled in)
Controlled by: DLNSEO
CUI Category: PRVCY
LDC: FEDCON
POC: [email protected]
Page 1 of 4
CUI (when filled in)
NATIONAL LANGUAGE SERVICE CORPS (NLSC)
DETAILED SKILLS SELF-ASSESSMENT
SECTION 2 - LISTENING.
FOR NLSC USE ONLY
CONTROL NUMBER
LANGUAGE:
INSTRUCTIONS: The following Self-Assessment of foreign language Listening Proficiency is intended to serve as a rough estimate of foreign language proficiency. It is not necessary
to know all the words or understand all the details of the texts listed for each item number below, but it is necessary in order to perform the functional tasks described at the indicated
level of accuracy. To estimate your level of proficiency, please read each task statement below and check “yes” if you believe you can perform the stated task and “no” if you do not
believe you can perform it. If a statement describes your ability only some of the time, or only in some contexts, you should answer “no”.
(X one)
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.
3. I can understand a co-worker introducing me to a friend in a
public place.
4. I can comprehend a telephone recording telling me a bank’s
business hours.
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.
YES
NO
(X one)
25. I can comprehend a talk to a group of parents in my
community about the merits of parental supervision where
the speaker attempts to persuade them to encourage their
children to be careful and act responsibly.
YES
NO
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 where the speaker attempts to persuade
them 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 understand national and international news on the radio
or on television.
28. I can comprehend what is said to me if 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
inspections 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.
NEEDS DD67
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 he/she 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 US.
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.
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 easily follow someone who explains their professional
responsibilities 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 the comments and challenges of
community members and local government officials at a
meeting where I defend my company’s policies for hiring and
laying off workers.
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 allow me to
understand anything that is said, whether in a sports
broadcast, college lecture, or public speech by a political
figure, 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.
23. I can understand co-workers at a meeting explaining or
discussing a project they are working on.
39. I can understand formal speech and informal speech,
including slang, dialect, cursing and jokes with double
meanings.
24. I can comprehend a presentation to students at a local
college on the merit of choosing my profession.
40. I can understand all forms of speech as well as a highly
educated native speaker of the language.
DD FORM 2933, 20210622 DRAFT
PREVIOUS EDITION IS OBSOLETE.
CUI (when filled in)
Page 2 of 4
CUI (when filled in)
NATIONAL LANGUAGE SERVICE CORPS (NLSC)
DETAILED SKILLS SELF-ASSESSMENT
SECTION 3 - SPEAKING.
FOR NLSC USE ONLY
CONTROL NUMBER
LANGUAGE:
INSTRUCTIONS: The following Self-Assessment of foreign language Speaking Proficiency is intended to serve as a rough estimate of foreign language proficiency. It is not
necessary to know all the words or understand all the details of the texts listed for each item number below, but it is necessary in order to perform the functional tasks described at the
indicated level of accuracy. To estimate your level of proficiency, please read each task statement below and check “yes” if you believe you can perform the stated task and “no” if you
do not believe you can perform it. If a statement describes your ability only some of the time, or only in some contexts, you should answer “no”.
(X one)
YES
(X one)
NO
1. I can tell/ask someone how to get from here to the nearest
hotel, restaurant, or post office.
25. I do not find it difficult to contribute to a conversation among
native speakers who try to include me.
2. I can order a simple meal at a restaurant.
26. 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.
3. I can negotiate a fair price for a hotel room or a taxi ride.
4. I can buy a needed item of clothing or a bus or train ticket.
5. I can respond correctly to standard questions about my
nationality, marital status, occupation, date and place of birth,
etc.
YES
NO
27. 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.
28. I can (on a social occasion) defend personal opinions toward
culture, race relations, or other sensitive subjects.
6. I can introduce myself appropriately.
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 handling situations or
problems covered in the previous statements.
9. I can describe my present or most recent job in some detail.
29. 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.
30. I feel that I have a professional command (rather than just a
practical one) of the language.
31. 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.
NEEDS DD67
10. I can give detailed information about my family, my house,
and the weather today.
11. I can hire an employee, or arrange for special services taking
care of details such as salary, qualifications, hours, specific
duties.
32. In professional discussion, my vocabulary is always
extensive and precise enough to enable me to convey my
exact meaning.
12. I can give a brief autobiography and talk about my immediate
plans and hopes.
33. I am able to alter my speech deliberately, depending upon
whether I am talking to university professors, supervisors,
subordinates, elders, close friends, employers, etc.
13. I can describe the basic structure of the U.S. Government or
of the U.S. educational system to someone unfamiliar with it.
34. I can serve as an informal interpreter for a U.S. senator or
cabinet official on all diplomatic and social functions.
14. I can describe the purpose or function of the organization I
represent.
35. I practically never make a grammatical mistake.
15. I can be understood (linguistically) by native speakers on
topics like those mentioned above most of the time.
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.
36. I can carry out any job assignment effectively in this
language.
37. 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.
18. I can describe in detail a person or place that is very familiar
to me.
38. 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.
19. I can discuss the parts of the body and general ailments
affecting them.
39. Educated native speakers assume that I am one of them.
20. I can tell someone what has been reported recently on
television news or in the newspaper.
40. I feel at home in this language
21. I can talk about a trip I took or some other everyday event
that happened in the recent past.
22. I can use the language well enough to assist someone
else,who does not know the language, in handling the
situations or problems covered in statements 9-21.
23. I do not avoid any grammatical features of the language
when speaking with a native speaker of the language.
24. I never find myself in the middle of a sentence I cannot finish
because of linguistic limitations (grammar of vocabulary).
DD FORM 2933, 20210622 DRAFT
PREVIOUS EDITION IS OBSOLETE.
41. I can do mental arithmetic in the language without slowing
down.
42. I consider myself a well educated native speaker of the
language.
43. I can easily make use of a broad range of idioms,
colloquialisms, and culture references in the language.
44. In discussions on all subjects, my vocabulary is always
extensive and precise, allowing me to convey my exact
meaning.
CUI (when filled in)
Page 3 of 4
CUI (when filled in)
NATIONAL LANGUAGE SERVICE CORPS (NLSC)
DETAILED SKILLS SELF-ASSESSMENT
SECTION 4 - WRITING.
FOR NLSC USE ONLY
CONTROL NUMBER
LANGUAGE:
INSTRUCTIONS: The following Self-Assessment of foreign language Writing Proficiency is intended to serve as a rough estimate of foreign language proficiency. It is not necessary to
know all the words or understand all the details of the texts listed for each item number below, but it is necessary in order to perform the functional tasks described at the indicated level
of accuracy. To estimate your level of proficiency, please read each task statement below and check “yes” if you believe you can perform the stated task and “no” if you do not believe
you can perform it. If a statement describes your ability only some of the time, or only in some contexts, you should answer “no”.
(X one) YES
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
7. I can prepare a classified advertisement that describes the
kind of apartment I want to rent.
8. I can send an email to my friend that describes in paragraphs
the house or apartment that I am staying in.
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.
NO
(X one) YES
25. I can write a newsletter article for parents in my community on
the merit of study-abroad programs (or similar types of issues)
that encourages them to allow their children to participate,
despite concerns over cost and safety.
NO
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.
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.
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.
NEEDS DD67
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 a 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 about the parts of the body, and general ailments
afflicting them.
15. I can write a description of a person’s physical characteristics.
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).
18. I can write a cover letter for a job application that describes in
detail the responsibilities that I had on my previous job.
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.
20. I can write an editorial for a newspaper stating my opinion on
the topic of adopting children from other countries (or a similar
topic) and support my views with examples and explanations.
21. I can write an essay that explains the process of a fair trial
(or a similar topic) in the US judicial system.
22. I can write a memo to my boss discussing a problem my
company is having, offer a solution to the situation, and
provide reasons for why I think my solution will be effective.
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.
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
to 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.
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.
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.
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.
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 during the
summer when area schools were not in session, and
introduce the planned initiatives.
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.
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.
DD FORM 2933, 20210622 DRAFT
PREVIOUS EDITION IS OBSOLETE.
CUI (when filled in)
Page 4 of 4
File Type | application/pdf |
File Title | DD Form 2933, "National Language Service Corps (NLSC) Detailed Skills Self-Assessment" |
File Modified | 2021-08-10 |
File Created | 2021-06-15 |