Self-Evaluation and Annual Report of Activities: 1996-1997

UMID:______

The University of Michigan – Flint Campus

PERFORMANCE EVALUATION

FOR THE PERIOD From To

Name: Date:

Department: Position title:

Part One: Please complete the first five columns of this chart, reviewing your own performance this year. You may need to consult with your supervisor to be sure you agree on how to state and prioritize your position’s major responsibilities. You and your supervisor will review the document together in your performance discussion, and your supervisor will decide the appropriate rating for each area, based on that discussion.

Major Responsibilities: / Prio-
rity / % of effort / Objectives/Goals: List any goals that were set for this year. / Summary of Accomplishments: Describe your work in this area of responsibility this year. Include specific examples of accomplishments. / Meet or Exceed /

Approa-

ches require-
ments / Does not meet require-
ments
1.
2.
3.
4.
5.

Note: if you are able to complete the form on line, the table will expand downward to fit your comments. To add an additional row, place your cursor in the bottom right hand cell and touch the tab key.

Performance Level Definitions

Meet or Exceed– Performance isconsistently effective and fully meets the key requirements of the position. Performance occasionally exceeds and rarely falls below standards. This staff member demonstrates the fine work expected of all of us at UM-Flint, and staff members should aim to achieve this rating on a regular and repeating basis.

Approaches Requirements – Performance meets established standards in some, but not all areas, and is not consistent in quality and output. Learning and performance development are occurring as needed.

Does Not Meet Performance Requirements – Performance does not meet established standards for the position and is below minimum expectations. The individual must improve performance to be out of this category within three months, or be working in a performance plan developed with the supervisor, in order to remain in this position.

Part Two:

I. Staff member, please describe:

I believe the following were especially significant accomplishments this year (Please list any that you would particularly like noted in this evaluation.)

I want to improve my performance in the following area(s):

Any other comments or concerns:

II. Supervisor, please complete the following:

The following achievements deserve special commendation this year:

I will be supporting you in improving performance in the following areas:

Any other comments or concerns:

Part Three:

Goals and Objectives for the coming year.

Major Responsibilities: / Priority / Objectives/Goals: List goals for the coming year.
1.
2.
3.
4.
5.

Overall rating for this performance period:Meet or ExceedApproaches requirementsDoes not meet requirements

Staff member signature and dateSupervisor signature and date