2015 Employee Performance Evaluation Form

2015 employee performance evaluation form

Employee:
Position Title:
Period of Evaluation:
/ Part 1 – Performance standards
Evaluate the employee’s performance since the last appraisal. List major job duties and responsibilities in order of importance. Circle the letter corresponding to the performance. Comments are encouraged, particularly feedback and suggestions for improvement; comments are required whenever an “E” or “U” is chosen.
E. Exceeds Expectations / Consistently achieves results superior to expectations.
M. Meets Expectations / Normally achieves expectations; occasionally exceeds requirements.
B. Below Expectations / Needs Improvement / Work is below average, not of a quality and quantity expected. Requires improvements.
U. Unsatisfactory / Far Below Expectations / Unacceptable. Considerable and immediate improvements are necessary.
/ List 3-5 major responsibilities of the position and circle evaluation letter, using the criteria above, for each responsibility. Benchmark to previous year’s goals, if available.
1. / E
M
B
U
2. / E
M
B
U
3. / E
M
B
U
4. / E
M
B
U
5. / E
M
B
U
/ In addition to the performance criteria for a specific position, all positions have general criteria for performance. Please rate the following using the definition of each element found in the document outlining the evaluation process.
1. Collaboration / E M B U
2. Problem Solving / E M B U
3. Communication / Interpersonal Skills / E M B U
4. Initiative and Creativity / E M B U
5. Conscientiousness / E M B U
6. Departmental, Organizational and/or Community Involvement / E M B U
7. Safety / E M B U
8. Dependability / Reliability / S NI U
/ Please provide comments to support the evaluation (use separate page, if necessary)
/ OVERALL RATING OF PERFORMANCE (check appropriate box)
8 / 7 / 6 / 5 / 4 / 3 / 2 / 1
Exceeds Expectations / Meets Expectations / Below Expectations / Unsatisfactory
/ Goals for employee for next 12 months (List 3-5 goals)
(If more space is needed, attach additional sheet)
/ General comments by supervisor
/ Comments by employee (optional)
/ Signatures below signify the supervisor and the employee have met and discussed the evaluation and the employee has received a copy.
Direct Supervisor Signature / Print / Typed Name / Date
Group Head Signature / Print / Typed Name / Date
Human Resource Signature / Print / Typed Name / Date
Employee Signature / Print / Typed Name / Date