FOR OFFICIAL USE ONLY — PRIVACY ACT OF 1974 APPLIES

Section I — Identification Data

1. Name (Last, First, Middle Initial) BAPTISTE, ANDRE

2. SSN ***-**-4891

3. Grade SSG

4. Pay Grade E-6

5. Date of Birth (YYYYMMDD) 19741210

6. Place of Birth (City, State/Country) New Orleans, LA

7. Sex M

8. Marital Status SINGLE

9. Citizenship US CITIZEN

10. Race / Ethnic Group BLACK / AFRICAN AMERICAN

11. Height 72 IN (6'0")

12. Weight 194 LBS (88 KG)

13. Home of Record Address (Street, City, State, ZIP) 1247 Deslonde St, New Orleans, LA 70117

14. Home Phone (504) 555-0147

Section II — Duty Information

15. Current Unit of Assignment H Co, 1st Bn, 121st Infantry (LRS), Georgia ARNG

16. UIC WGAA1H

17. Station (Installation/City) Richard County, GA

18. Primary MOS 91W4O (Health Care Specialist)

19. Additional MOS N/A

20. Duty Position Title Senior Combat Medic

21. Position MOS 91W4O

22. BASD (Basic Active Svc Date) 19930601

23. PEBD (Pay Entry Basic Date) 19930601

24. ETS FED ACTIVATION / N/A

25. DEROS N/A

26. Security Clearance Level SECRET

27. Date Granted 20020815

28. Issuing Authority DIA / DCSINT, DA

Section III — Emergency Data / Next of Kin

29. Primary NOK Name (Last, First) BAPTISTE, ENERO

30. Relationship FATHER

31. Phone Number (504) 555-0147

32. NOK Address (Street, City, State, ZIP) 1247 Deslonde St, New Orleans, LA 70117

33. Relationship Code F (FATHER)

34. Secondary NOK Name (Last, First) BAPTISTE, NANEI

35. Relationship MOTHER

36. Phone Number (504) 555-0147

Section IV — Education

37. Highest Civilian Education Level HIGH SCHOOL DIPLOMA

38. Major / Field of Study N/A

39. Year Completed 1992

40. College/University Name N/A

41. Religious Preference ROMAN CATHOLIC

42. Remarks N/A

FOR OFFICIAL USE ONLY — PRIVACY ACT OF 1974 APPLIES

Section V — Assignment / Duty History

From (YYYYMM)	To (YYYYMM)	Unit / Organization	Station / Location	Duty Position / Title	Remarks
199306	199309	BCT, Ft. Jackson Reception Bn	Columbia, SC	Trainee	Graduate
199309	199402	AMEDD C&S, 91W AIT	Ft. Sam Houston, TX	Student, 91W AIT	Distinguished Graduate
199402	199712	Ft. Sam Houston, 9th Med Co	Ft. Sam Houston, TX	Combat Medic	Active Duty
199712	200001	H Co, 1-121 INF, Georgia ARNG	Hinesville, GA	Combat Medic (M-Day)	Initial ARNG Assignment
200001	200302	H Co, 1-121 INF (LRS), Georgia ARNG	Hinesville, GA	Team Medic (LRS)	Promoted SSG 20021001
200302	200305	221st MI Bn (TCS — OIF I)	Baghdad, Iraq (AO)	Team Medic, LRS Recon	OIF I — Invasion Phase
200305	200309	203rd MI Bn (TCS — OIF I)	Baghdad, Iraq (AO)	Senior Medic, WMD Recovery	OIF I — WMD Ops; KIA SFC Willoughby 20030720
200309	200401	H Co, 1-121 INF, Georgia ARNG	Hinesville, GA	Senior Combat Medic	Post-Deployment Reintegration
200401	PRESENT	H Co, 1-121 INF (LRS), Georgia ARNG	Richard County, GA	Senior Combat Medic	State Active Duty — Outbreak Ops



Additional assignments on file with G-1 / S-1. Continue on DA Form 2-1 continuation sheet if needed.

Section VI — Overseas and Combat Service

Total Overseas Service (Years / Months) 0 YRS / 7 MOS

Combat Service — Theater(s) OIF — Iraq / Southwest Asia

Dates of Combat Service 20030207 – 20030930

Overseas/Combat Service Remarks OIF I — Federally activated 20030207; attached to 221st MI Bn for invasion phase; detached to 203rd MI Bn (200305) for high-risk WMD site recovery ops in Baghdad AO. Sustained combat operations under direct hostile fire. Unit sustained first Georgia ARNG KIA since Korean War (SFC Christopher Willoughby, 20030720). Redeployed 20030930.

FOR OFFICIAL USE ONLY — PRIVACY ACT OF 1974 APPLIES

Section VII — Awards, Decorations, and Badges

Awards and Decorations (List all — most recent first) Army Commendation Medal (ARCOM); Iraq Campaign Medal (ICM) w/ 2 Campaign Stars; Global War on Terrorism Expeditionary Medal (GWOTEM); Global War on Terrorism Service Medal (GWOTS); National Defense Service Medal (NDSM); Army Achievement Medal (2nd Award); Army Service Ribbon (ASR)

Badges / Tabs Combat Medical Badge (CMB); Expert Field Medical Badge (EFMB); Long Range Surveillance (LRS) Leader Tab

Authorized Unit Awards Meritorious Unit Commendation (MUC) — H Co, 1-121 INF, OIF I

Section VIII — Prior Service / Enlistment Data

Date of Initial Entry (YYYYMMDD) 19930601

Enlistment Station New Orleans, LA (MEPS)

Enlistment Option / Program Option 4B — Combat Medic (91W)

RE Code at Last Separation RE-1 (Currently Serving)

Enlistment Date	Separation Date	Component / Branch	Unit / Station	Separation Code	Character of Svc
19930601	19971130	US Army Active / AMEDD	Ft. Sam Houston / Various	LBK (Transfer to ARNG)	HONORABLE
19971201	20030207	Georgia Army National Guard	H Co, 1-121 INF, Hinesville GA	M-Day (Fed. Activated)	HONORABLE
20030207	PRESENT	Georgia ARNG / Federal Active Duty	OIF / Richard County, GA	Currently Serving	HONORABLE

Section IX — Disciplinary / Administrative Actions

Article 15 Actions on File NONE

Courts-Martial on File NONE

Flag / Suspension of Favorable Actions NONE

Security Incidents on File NONE

Disciplinary Remarks / Disposition NO ADVERSE ACTIONS OF ANY KIND ON FILE. Soldier has maintained an unblemished service record throughout entire enlistment. Character of service consistently rated Honorable across all components. No flags, suspensions, or administrative actions of any nature.

Section X — Authentication

Soldier Signature /s/ André Baptiste

Date Reviewed by Soldier (YYYYMMDD) 20040115

Prepared By (Name, Grade, Position) WEBB, Marcus D., SFC, Team Sergeant, H Co 1-121 INF

Date Prepared 20040114

Telephone (DSN) DSN 870-4492

FOR OFFICIAL USE ONLY — PRIVACY ACT OF 1974 APPLIES

Section I — MOS / Skill Qualification History

Primary MOS / Skill Identifier 91W4O — Health Care Specialist

Date Awarded (YYYYMM) 199402

Additional MOS(s) N/A

ASI / SQI Code(s) 5M (MOPP Medical Ops); F3 (TCCC Instructor)

Language Proficiency (Code) EN — English (Native)

DLPT Date N/A (Native Speaker)

Listening Score Native / 3+

Reading Score Native / 3+

Section II — Military Education and Schools

Course / School	Institution / Installation	From (YYYYMM)	To (YYYYMM)	Graduate (Y/N)	Remarks
Basic Combat Training (BCT)	Ft. Jackson, SC	199306	199309	Y	Distinguished Graduate
Advanced Individual Training (AIT) — 91W Health Care Specialist	AMEDD C&S, Ft. Sam Houston, TX	199309	199402	Y	Top of Class; Dean's List
NBC Medical / MOPP Operations Course	Ft. Leonard Wood, MO	200012	200101	Y	ASI 5M Awarded
Primary Leadership Development Course (PLDC)	Ft. Stewart, GA	200009	200011	Y	Commandant's List
Long Range Surveillance (LRS) Leader Course	Ft. Benning, GA	200112	200202	Y	LRS Leader Tab Awarded
Tactical Combat Casualty Care (TCCC)	Ft. Campbell, KY	200212	200301	Y	Certified TCCC Instructor
Expert Field Medical Badge (EFMB) Testing	Ft. Stewart, GA	200110	200110	Y	Awarded on First Attempt

Section III — Army Physical Fitness Test (APFT) Record

Date (YYYYMM)	Age Group	Push-ups (Score)	Sit-ups (Score)	2-Mile Run (Time)	Total Score	Result
200101	22–26	74 (90)	79 (99)	13:08 (93)	282	GO
200107	22–26	76 (93)	80 (100)	13:02 (95)	288	GO
200207	27–31	72 (94)	77 (97)	13:24 (91)	282	GO
200301	27–31	74 (97)	78 (98)	13:18 (92)	287	GO

FOR OFFICIAL USE ONLY — PRIVACY ACT OF 1974 APPLIES

Section IV — Weapons Qualification Record

Soldier Name (Last, First, MI) BAPTISTE, ANDRE

SSN ***-**-4891

Unit H Co, 1-121 INF (LRS), Georgia ARNG

Date (YYYYMM)	Weapon System	NSN / Type	Range (Name)	Hits / Shots	Score / Go-NoGo	Qual Level
200101	M16A2 / M4 Carbine	M4A1	Ft. Stewart, GA	36/40	36 / GO	EXPERT
200112	M16A2 / M4 Carbine	M4A1	Ft. Benning, GA	37/40	37 / GO	EXPERT
200302	M16A2 / M4 Carbine	M4A1	Udairi Range, Kuwait	38/40	38 / GO	EXPERT
200107	M9 Pistol	M9	Ft. Stewart, GA	40/50	40 / GO	SHARPSHOOTER
200302	M9 Pistol	M9	Udairi Range, Kuwait	44/50	44 / GO	SHARPSHOOTER
200112	M203 Grenade Launcher	M203	Ft. Benning, GA	GO	GO	QUALIFIED
200302	M249 SAW	M249 PIP	Udairi Range, Kuwait	N/A	GO	QUALIFIED





Qualification levels: MARKSMAN (23–29 hits), SHARPSHOOTER (30–35), EXPERT (36–40). Record complete history; annotate any alternate course or modified record fire.

Section V — Additional Certifications / Licenses

Certification / License Title National Registry EMT-Basic (NREMT-B)

Issuing Authority NREMT

Date Issued (YYYYMM) 199402

Expiration (YYYYMM) ACTIVE (Renewed 200212)

Certification / License Title Tactical Combat Casualty Care Instructor (TCCC-I)

Issuing Authority US Army AMEDD C&S

Date Issued (YYYYMM) 200301

Expiration (YYYYMM) ACTIVE

Training Certifier (Name, Grade) WEBB, Marcus D., SFC

Signature /s/ M. Webb

Date 20040114

FOR OFFICIAL USE ONLY — PRIVACY ACT OF 1974 APPLIES

Part I — Administrative Data

a. Name (Last, First, MI) BAPTISTE, ANDRE

b. SSN ***-**-4891

c. Rank SSG

d. Date of Rank 20021001

e. Unit, Org, Station, ZIP+4 or APO H Co, 1-121 INF (LRS), Georgia ARNG, APO AE 09320

f. UIC WGAA1H

g. PMOS / Skill Level 91W4O

h. Period Covered — From (YYYYMM) 200302

h. Period Covered — Thru (YYYYMM) 200309

i. Rated Months 7

j. Reason for Submission (Code) 06 — Change of Rater

k. Rated NCO's Commander — Name, Rank, Position HARGROVE, James E., CPT, Commanding Officer, H Co 1-121 INF

l. Commander's Signature / Date /s/ J. Hargrove / 20031215

Part II — Authentication

a. Rater Name (Last, First, MI) WEBB, Marcus D.

Rank SFC

Position / Title Team Sergeant

Signature / Date /s/ M. Webb / 20031210

b. Intermediate Rater Name (Last, First, MI) — if applicable N/A

Rank N/A

Position / Title N/A

Signature / Date N/A

c. Senior Rater Name (Last, First, MI) HARGROVE, James E.

Rank CPT

Position / Title Company Commander

Signature / Date /s/ J. Hargrove / 20031215

d. Rated NCO Acknowledgment — signs after Rater and Senior Rater (signature does not constitute agreement) /s/ André Baptiste

Date 20031218

Part III — Duty Description

a. Principal Duty Title Senior Combat Medic / Team Medic

b. Duty MOS / ASI / SQI 91W4O / 5M / F3

c. Hrs Per Day Supervised 24 (Combat Ops)

d. # Soldiers Org (Total in unit) 54

d. # Soldiers Directly Supervised 6

e. Equipment / Resources Supervised (Dollar Value) $52,000 (Medical Equipment, Comms, Individual Weapons)

f. Daily Duties and Scope Sole medical authority for 6-man LRS team conducting deep, unsupported reconnaissance in denied AO. Performs emergency trauma care (cricothyroidotomy, needle decompression, IO access) without physician oversight. Manages Class VIII supply chain for extended mission profiles. Conducts intelligence-driven CASEVAC planning. Advises team leader on medical risk assessment during all mission planning phases.

g. Areas of Special Emphasis CBRN/WMD mass-casualty triage; MOPP Level IV medical operations; nerve agent recognition and emergency antidote administration (Mark 1 NAAK); airway management in restrictive MOPP gear.

h. Appointed Duties (Collateral / Additional Duties) Unit NBC Medical NCO; TCCC Course Instructor (Company-level); Primary CASEVAC Planner for all team insertions.

FOR OFFICIAL USE ONLY — PRIVACY ACT OF 1974 APPLIES

Part IV — Army Values / NCO Responsibilities

a. Army Values
(YES = meets standard)

LOYALTY

DUTY

RESPECT

SELFLESS SERVICE

HONOR

INTEGRITY

PERSONAL COURAGE

YES

Values narrative — required if any NO checked above: — No values deficiencies noted. All standards met or exceeded across the full rated period including sustained combat operations.

b. COMPETENCE Possesses and maintains the skills and knowledge necessary to accomplish all tasks and missions

Demonstrates technical and tactical proficiency. Maintains MOS and functional skills. Trains self to standard. Makes sound decisions.

EXCELLENCE SUCCESS NEEDS IMPROVEMENT

Competence — Rater bullets: — Maintained sole medical authority for LRS team throughout 7 months of unbroken combat ops; zero preventable deaths under his direct care — Performed emergency airway management and hemorrhage control under direct enemy fire on multiple occasions; executed without error in all documented instances

c. PHYSICAL FITNESS & MILITARY BEARING Maintains physical fitness and presents a professional military appearance

Meets Army weight and fitness standards. Presents a professional appearance. Sets the example in physical readiness.

EXCELLENCE SUCCESS NEEDS IMPROVEMENT

Physical Fitness & Military Bearing — Rater bullets: — Consistently scored 280+ on APFT; maintained peak fitness while humping an overweight 68-lb medic kit on all LRS infiltrations without reduction in mission effectiveness — Demonstrated exemplary bearing in garrison and under extreme operational stress; composure under hostile fire was formally noted by the full chain of command

d. LEADERSHIP Develops and inspires soldiers to accomplish any mission in any environment

Sets the example. Accomplishes the mission. Cares for soldiers. Builds cohesive teams. Communicates effectively up and down the chain.

EXCELLENCE SUCCESS NEEDS IMPROVEMENT

Leadership — Rater bullets: — Served as the primary stabilizing presence within the team following KIA of SFC Willoughby (20030720); maintained team cohesion and operational effectiveness under severe morale strain — Trained all 6 team members to Combat Lifesaver standard; measurably reduced casualty response times across the entire element

FOR OFFICIAL USE ONLY — PRIVACY ACT OF 1974 APPLIES

Part IV — Army Values / NCO Responsibilities (cont.)

e. TRAINING Trains soldiers and units to standard and leads training to achieve mission requirements

Plans, prepares, and executes training. Evaluates training and takes corrective action. Ensures soldiers are trained to standard.

EXCELLENCE SUCCESS NEEDS IMPROVEMENT

Training — Rater bullets: — Designed and delivered company-level TCCC program prior to OIF I; certified 14 soldiers as Combat Lifesavers; program adopted as battalion standard — Developed novel MOPP IV trauma protocol for WMD recovery ops; procedure incorporated into 203rd MI Bn SOP within 30 days of submission

f. RESPONSIBILITY & ACCOUNTABILITY Maintains and accounts for personal and organizational property and upholds the Army ethic

Accepts full responsibility for actions and results. Maintains accountability of equipment, funds, and personnel. Upholds standards.

EXCELLENCE SUCCESS NEEDS IMPROVEMENT

Responsibility & Accountability — Rater bullets: — Maintained 100% accountability of $52,000 Class VIII medical equipment throughout 7-month combat deployment; zero losses or shortfalls reported at any point — Submitted full clinical AAR for SFC Willoughby KIA with documented precision; after-action review found no improvable actions on SSG Baptiste's part

Part V — Overall Performance and Potential (Senior Rater)

a. Overall Performance

SUPERIOR EXCELLENT AMONG THE BEST MARGINAL FAILURE

b. Overall Potential for Promotion / Greater Responsibility

BEST QUALIFIED FULLY QUALIFIED DO NOT PROMOTE

c. Senior Rater Narrative (mandatory — bullet format): — SSG Baptiste is the finest combat medic I have evaluated in 15 years; his OIF I performance was extraordinary without exception — Performed trauma care under sustained hostile fire; his skill and composure directly preserved lives that would otherwise have been lost — Recommend immediate promotion to SFC and priority consideration for SF 18D pipeline; do not waste this NCO below Master Sergeant

d. Senior Rater Signature /s/ James E. Hargrove, CPT, Commanding

Date (YYYYMMDD) 20031215