☐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 - UnsatisfactoryPerformance 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