6 Month Review Annual Other

Employee Performance Appraisal Form

☐6 month Review ☐Annual ☐Other:

Supervisor: Supervisor UA ID:

Position Title: Department:

Appraisal Periodfrom: to:

MISSION: The University of Alaska Fairbanks is a Land, Sea, and Space Grant university and an international center for research, education, and the arts, emphasizing the circumpolar North and its diverse peoples. UAF integrates teaching, research, and public service as it educates students for active citizenship and prepares them for lifelong learning and careers.

Rating Levels:

5 – Excellent / 4 – Exceeds Expectations / 3 – Meets Expectations / 2 – Needs Improvement / 1 - Unsatisfactory
Performance Factor
(Use Performance Factor Definitions as a Guide) / Employee
Rating / Supervisor
Rating
I: Communications

Skill and Clarity

Interpersonal Characteristics

Teamwork

Builds and Enhances Relationships

Employee Comments:
Supervisor Comments:
II. Competency

Job Knowledge

Comprehension

Judgmentand Decision Making

Problem-Solving

Straightforwardness and Composure

Employee Comments:
Supervisor Comments:
III. Results

Resourcefulness

Perseverance

Agility

Meets Objectives

Employee Comments:
Supervisor Comments:
IV. Responsibility

Ethics

Dependability

Supports Diversity

Safety

Employee Comments:
Supervisor Comments:
V. Character/Values (or Emotional Intelligence)

Empathy

Conduct

Core Values

Employee Comments:
Supervisor Comments:
VI. Leadership and/or Management

Planning

Execution

Organization

Innovation

Style

Change Agent

Evaluations of subordinates are complete

Employee Comments:
Supervisor Comments:
VII. Professional Development
Check any that apply / Interested in career growth and available within department: Career Development Plan approved / Interested in career growth and available within department: has NOT completed a Career Development Plan / Interested in career growth but not available at this time within department: Will work on continued professional development and interests / Working well,
Well placed and content in position / Needs some additional training in current position to be effective
☐ / ☐ / ☐ / ☐ / ☐
Professional Development discussed during evaluation:
VIII: Performance Goals
Performance Goals should support the University’s mission, core competencies and core values. Identify goals that were set at the beginning of the performance cycle and summarize substantive accomplishments. List at least one goal. Additional sheets can be attached to this section if more space is required.
Last Appraisal Period Goals / Accomplishments / Supervisor Feedback
IX. Performance Goals for the Next Appraisal Period
Goals for the upcoming appraisal period are collaboratively identified with supervisor and employee, with accompanying measurements and timeline stated for each goal. List at least one goal. Additional sheets can be attached to this section if space is required. The supervisor and employee should refer to this form as they meet periodically throughout the review period to discuss progress. These goals should be reviewed periodically and updated with any changes, deletions, or additions as determined to be necessary.
Next Appraisal Period from: to:
Next Appraisal Period Goals / Measurement

Employee Review: The contents of this form have been reviewed with me. I understand whether or not I agree with this evaluation I may enter my opinions here or on an attached sheet of paper delivered to HR within 30 days from the date of my evaluation meeting. I understand that I have the right to discuss this evaluation with a Human Resources representative and/or to discuss this evaluation with the second level supervisor.

Employee Signature: ______Date: ______

Employee Comments (use back or attach additional sheet(s), if necessary):
Rater/Supervisor Signature / Date:
Next Level Supervisor/Dept. Mgr./VP Signature
(optional, butrequired if evaluation is well below average) / Date:

Performance Factor Definitions

Draft Rev. 1/29/2016