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POTFF Resume Checklist
| Appendix 3 - POTFF Resume Checklist | | | |
| Position Title/Billet #: Name of Individual: | | | |
| Completed and Verified (circle one) | | |
| Is the applicant a current incumbent employee under this contract or the previous H92222-13-D-0004? If yes, list current title and location as well as if they are being submitted for the same or new position. | YES | NO | |
| Position Requires Credentialing by the applicable MTF per Section H.11 | YES | NO | N/A |
| Position Requires In-Person Interview Per Appendix 2 and H.11 | YES | NO | N/A |
| Individual meets all Minimum Qualification Requirements outlined within PWS Appendix 1. (If No, and Waiver is being requested IAW PWS 2.4, attach request to resume and provide explanation here. | YES | NO | N/A |
| 1. Security and Privileges | | | |
| Security Clearance: (Enter Status/Level/Date here) (If interim clearance is being requested per H., attach request to resume and provide explanation here). | YES | NO | N/A |
| Favorable National Agency Check (NACI) IAW H.14: (Enter completed date here) | YES | NO | N/A |
| Are there any circumstances that may hinder security clearance approvals? (If Yes, provide explanation) | YES | NO | N/A |
| Has this individual ever been arrested or charged with a crime? If so, provide a description of the disposition of the arrest or charge. | YES | NO | N/A |
| Clinical Privileges (IAW H.11): Has the HCP, within 5 years of performance, had his/her clinical privileges limited, suspended, or revoked by any health care facility, public or private, anywhere in the world? (If yes, provide explanation IAW H.11) | YES | NO | N/A |
| 2. List Education/Certifications/Licensure (as required) is listed on the Resume: Each citation shall include name/title of degree/certification, year achieved/awarded, and institution issued from/awarded by. | | |
| YES | NO | N/A |
| 3. Provide a position crosswalk by labor category requirements (As Applicable). (This section should only be used for Athletic Trainer, HP Program Advisor, Physical Therapist, Sports Dietitian, Sports Psychologist, Strength and Conditioning Specialist.. All others see Section 4 below) | | | |
| YES | NO | N/A | |
| NCAA Experience (total years): | YES | NO | N/A |
| Position Titles: e.g. Intern Performance Nutritionist, Assistant Performance Dietitian, Head Performance Dietitian | YES | NO | N/A |
| Respective Locations & Respective Years: e.g. University of Alabama - 1 yr, Campbell University - 4 yrs, Texas A&M University - 2 yrs | YES | NO | N/A |
| Respective NCAA Divisions: e.g. I, II, I | YES | NO | N/A |
| Professional Sports Experience (total years): | YES | NO | N/A |
| Position Titles: e.g. Staff Physical Therapist (PT), Team Associate Director PT, Team Lead PT | YES | NO | N/A |
| Respective Locations & Respective Years: e.g. Tampa Bay Buccaneers - 1 yr, Tampa Bay Rays - 4 yrs, Tampa Bay Lightening - 2 yrs | YES | NO | N/A |
| Olympic Sports Experience (total years): | YES | NO | N/A |
| Position Titles: e.g. Intern S&C Coach, Assistant S&C Coach, Head S&C Coach | YES | NO | N/A |
| Respective Locations & Respective Years: e.g. USA Olympic Training Center (CO) -1 yr, USA Ski & Snowboard - 4 yr, USA Hockey - 2 yrs | YES | NO | N/A |
| SOF Operator training/employment experience (total years): | YES | NO | N/A |
| Position Titles: e.g. Intern Cognitive Coach, Assistant Sport Psychologist Coach, Head Cognitive Performance Specialist | YES | NO | N/A |
| Respective Locations: e.g. Naval Special Warfare - 1 yr, Marine Special Operations Command - 4 yrs, 75th Ranger Regiment - 2 yrs | YES | NO | N/A |
| 4. Provide a position crosswalk for All Other POTFF labor categories: Insert PWS Requirement and Individual Quals and Experience within the Resume. | YES | NO | N/A |
| Verified By (Insert Name and Signature): ___________________________________________________ | | | |
| Date Verified: | | | |
| Date Submitted to Appropriate COR: | | | |