Performance Management (Work Plan, Annual Appraisal) and Career Development Form

This form should be retained in electronic format, updated throughout the Performance Cycle as changes to the Work Plan, Annual Performance Appraisal, or Career Development Plan are needed or required. At the end of the Performance Cycle, the completed document, with all applicable signatures should be submitted to Human Resources. Upon development of this form for a new employee, submit the applicable pages, along with front page and signatures to Human Resources for placement in the employee’s personnel file.

Section I. Position Demographic Information
UNC Charlotte ID / Name of Current Employee / Position Number / “WORKING” Title of position
8 0
Approved Classification of this position & Grade / Division / College or Department / Departmental Sub Unit / Section
Name of Immediate Supervisor / Supervisor’s Position Title / Supervisor’s Position Number / Name of Reviewer / Manager
(Supervisor of the Supervisor) / Reviewer’s Position Title / Reviewer’s Position Number
If employee has been in this position for less than one (1) calendar year, please indicate start date
Section II. Final Performance Appraisal Ratings & Review Process Signatures
Initial Work Planning Discussion
(Signatures required only at beginning of employment in position or when work plan expectations have changed Signature indicates supervisor has discussed work plan, competency profile and expected level of competency with employee ). / Interim Review Discussion (mid-cycle)
If an Interim Review Improvement Plan is completed, attach it to the Annual Appraisal and submit to Human Resources at the end of the Performance Cycle
Employee Signature:______Date:______
Supervisor Signature:______Date:______
Reviewer/Manager Signature:______Date:______ / Employee Signature:______Date:______
Supervisor Signature:______Date:______
Reviewer/Manager Signature:______Date:______
Performance Appraisal Ratings
Performance Cycle Begin Date / Performance Cycle End Date / Performance Appraisal Overall / Final Rating
(Place an ‘X’ in the box to the left of the Overall Performance Rating you chose)
5
(Outstanding) / 4
(Very Good) / 3
(Good) / 2
(Below Good) / 1
(Unsatisfactory)
Employee, Supervisor, and Reviewer Signatures
End of Cycle Performance Appraisal
Employee Signature:______Date:______
Supervisor Signature:______Date:______
Reviewer/Manager Signature:______Date:______
Request Response from Reviewer / Please understand that your signature indicates only that you have read and discussed this performance evaluation with your supervisor. It does not necessarily mean that you agree with the evaluation’s contents. If you disagree with your appraisal, explain, either in space within this document or on a separate page, the specific areas of disagreement. An employee who has a complaint or dissatisfaction regarding performance pay disputes shall have the opportunity to present a grievance in accordance with procedures outlined in PIM-35, Grievance and Appeals Procedures for Employees Subject to the State Personnel Act. The employee has 15 calendar days after completion of the performance appraisal to initiate such a grievance through the Department of Human Resources. If you wish a response from the reviewing official, place an ‘X’ in the box to the left.