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PERFORMANCE EVALUATION FORM

Employee Name: Job Title: Employee ID Number: Department: Supervisor’s Name: Review Period Review Period Beginning Ending:

Job Performance Ratings

GE = Greatly Exceeds Expectations

E = Exceeds Expectations

M = Meets Expectations

P = Partially Satisfies Expectations

F = Fails to Meet Expectations

Job Factor Examples GE E M P F Quality of Work Quantity of Work Timely Performance of Work Analysis, Decisions, or Judgement Initiative Interpersonal Skills Communication – Oral Communication – Written Ability to Follow Instructions Customer Orientation Budgeting Leadership Hiring Other:

Performance Summary For This Review Cycle List the employee’s major goals or accountabilities for the just-completed work plan:

To what extent was the employee successful in meeting agreed on goals and accountabilities? Provide examples.

Performance Goals For Next Review Cycle

List the employee’s major goals or accountabilities agreed on as part of the work plan for the new work cycle:

Development Plans

Use the space below to describe training or development plans for the new work cycle.

Overall Rating

☐ Greatly Exceeds Expectations ☐ Exceeds Expectations ☐ Meets Expectations ☐ Partially Satisfies Expectations ☐ Fails To Meet Expectations

Supervisors Comments

Use the space below to record any other comments regarding the employee’s job performance.

Acknowledgement and Approvals Supervisor’s Acknowledgement I have met with the above-named employee to discuss and review this performance evaluations Supervisor’s Signature: Date:

Employee’s Acknowledgement I have had the opportunity to review this performance evaluation and to discuss it with my supervisor. Employee’s Signature: ** Note: Signing does not mean agreement to the appraisal, merely that the employee has reviewed and discussed with his or her supervisor. Date:

Employee’s Comments

Use the space below to record your comments regarding your supervisor’s evaluation of your job performance.

Department Manager’s Approval

Department Managers Signature: Date: