PERFORMANCE APPRAISAL

Employee Name:

Position/Title:

Supervisor’s Name:

Using the following scale:

Excellent - 5 / Very Good - 4 / Satisfactory - 3 / Improvement Needed - 2 / Unsatisfactory - 1

Assign a score, 1 to 5, for each of the following attributes (if an attribute does not apply to the employees job and/or duties, enter N/A):

Attribute / N/A / 1 / 2 / 3 / 4 / 5
1. Quantity of Work
2. Quality of Work
3. Job Knowledge
4. Initiative
5. Judgment / Prioritization
6. Acceptance of Responsibility
7. Adaptability
8. Dependability
9. Attendance / Punctuality
10. Cooperation
11. Adherence to Company Policy
12. Customer Service
13. Safety
14. Work Environment
Supervisory/Managerial Attributes / N/A / 1 / 2 / 3 / 4 / 5
1. Leadership
2. Decision Making / Judgment
3. Planning
4. Time Management
5. Problem Solving
6. Staff Development
7. Employee Performance Appraisals
8. Cost Efficiency
9. Workplace Relationships


OVERALL RATING:

Total Number of Attributes Rated (do not include any attribute deemed N/A) =

Total Rating Points (sum of all ratings, 1-5, assigned for each attribute rated) =

Overall Rating: / _____Total Rating Points_____
Total Number of Attributes Rated /
= ------=

Check appropriate box below.

4.1 – 5.0 Excellent
3.1 – 4.0 Very Good
2.1 – 3.0 Satisfactory
1.1 – 2.0 Improvement Needed
0 – 1.0 Unsatisfactory / Unacceptable Performance

Employee’s Comments: (reserved for employee. If no comment, check and initial below)

[ ] I have been given the opportunity to have my comments included as a part of this Performance Appraisal and have chosen not to do so. ______(initial)

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Employee: your signature certifies that you have had the opportunity to read and discuss this Appraisal with your supervisor. Your signature does not imply that you agree or disagree with this Appraisal.

Employee Signature: ______Date: ______

Appraisal Completed by (Supervisor): ______Date: ______

Approved by: ______Date: ______