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Performance Management Appraisal Form

This 3-page document is a performance appraisal form that contains: 1) Sections to evaluate an employee's performance on key tasks and dimensions using a rating scale and calculate an overall performance score. 2) Space for comments by the supervisor to support their ratings. 3) Signatures by the employee and supervisor. 4) Optional sections for the employee's career goals and a development plan.

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mrsfox
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110 views8 pages

Performance Management Appraisal Form

This 3-page document is a performance appraisal form that contains: 1) Sections to evaluate an employee's performance on key tasks and dimensions using a rating scale and calculate an overall performance score. 2) Space for comments by the supervisor to support their ratings. 3) Signatures by the employee and supervisor. 4) Optional sections for the employee's career goals and a development plan.

Uploaded by

mrsfox
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
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PERFORMANCE MANAGEMENT

APPRAISAL FORM

Employee’s Name: Banner #:

Position Title: Grade:

Department/Office:

Evaluation Period From: To:

Annual
Type of Appraisal:

Special (Change of Supervisor, change of position, employee leaves University etc.)


Employee’s Name:

Significant Task/Responsibility:
(Taken from Workplan)

Supervisor’s Comments: (Must support the rating points given)

Weight Ratings Points Task Score


(Transfer from Work Plan) (1-5) Multiply Weight and Rating
Points for Total

Significant Task/Responsibility:
(Taken from Workplan)
:
Supervisor’s Comments: (Must support the rating points given)

Weight Ratings Points Task Score


(Transfer from Work Plan) (1-5) Multiply Weight and Rating
Points for Total

RATING POINTS:
5 = Outstanding; 4 = Very Good; 3 = Good, Meets Expectations; 2 = Below Good; 1 = Unsatisfactory

Duplicate form as necessary


Employee’s Name:

Significant Task/Responsibility:
(Taken from Workplan)

Supervisor’s Comments: (Must support the rating points given)

Weight Ratings Points Task Score


(Transfer from Work Plan) (1-5) Multiply Weight and Rating
Points for Total

Significant Task/Responsibility:
(Taken from Workplan)
:
Supervisor’s Comments: (Must support the rating points given)

Weight Ratings Points Task Score


(Transfer from Work Plan) (1-5) Multiply Weight and Rating
Points for Total

RATING POINTS:
5 = Outstanding; 4 = Very Good; 3 = Good, Meets Expectations; 2 = Below Good; 1 = Unsatisfactory

Duplicate form as necessary


Employee’s Name:

Significant Task/Responsibility:
(Taken from Workplan)

Supervisor’s Comments: (Must support the rating points given)

Weight Ratings Points Task Score


(Transfer from Work Plan) (1-5) Multiply Weight and Rating
Points for Total

Dimension:
(Taken from Workplan)
:Supervisor’s Comments: (Must support the rating points given)

Weight Ratings Points Dimension Score


(Transfer from Work Plan) (1-5) Multiply Weight and Rating
Points for Total

RATING POINTS:
5 = Outstanding; 4 = Very Good; 3 = Good, Meets Expectations; 2 = Below Good; 1 = Unsatisfactory

Duplicate form as necessary


Employee’s Name:

Dimension:
(Taken from Workplan)

Supervisor’s Comments: (Must support the rating points given)

Weight Ratings Points Dimension Score


(Transfer from Work Plan) (1-5) Multiply Weight and Rating
Points for Total

Dimension: Customer Service


(Taken from Workplan)
:Supervisor’s Comments: (Must support the rating points given)

Weight Ratings Points Dimension Score


(Transfer from Work Plan) (1-5) Multiply Weight and Rating
Points for Total

RATING POINTS:
5 = Outstanding; 4 = Very Good; 3 = Good, Meets Expectations; 2 = Below Good; 1 = Unsatisfactory
Duplicate form as necessary

Employee’s Name:

Supervisor’s Statement Summarizing the Employee’s Overall Performance

Calculate the average Overall Performance Rating by dividing the total Rating Points by the total of the
Weights assigned. (NOTE: The average Overall Performance Rating should be reported to the nearest
hundredth by rounding: e.g., 3.385 would be rounded up to 3.39, and 3.384 would be rounded down to
3.38.)

PERFORMANCE RATING SCALE Total Total Overall


Rating / Weights = Performance
4.50 – 5.00 Outstanding Scores Rating
3.50 –4.49 Very Good
3.00 – 3.49 Good
2.75 – 2.99 Below Good
1.00 – 2.74 Unsatisfactory

Was an Interim Review discussion conducted with employee? YES NO

Performance Improvement Plan: For each significant task and/ or dimension that the supervisor evaluates
as “Below Good” or “Unsatisfactory”, an improvement plan must be developed and attached. The
Improvement Plan should be discussed with the employee during the appraisal. The Reviewer must sign
all documents if an improvement plan is completed. Is an Improvement Plan attached? YES NO
N/A

Employee’s Signature ________________________________________ Date _____________

Supervisor’s Signature ________________________________________ Date _____________

Reviewer’s Signature ________________________________________ Date _____________

I am not in agreement with my appraisal score.


Employee Signature___________________________________________ Date _____________
EMPLOYEE’S STATEMENT OF CAREER PLANS AND GOALS (OPTIONAL)

It is policy of the University to fill job vacancies with qualified individuals from within when possible. An employee is
encouraged to utilize available resources to enhance their knowledge and skills for professional growth, and to document plans
and goals. You have the option stating your career plans and goals at this time.

DEVELOPMENT PLAN (OPTIONAL)

Developmental opportunities provide incentive for an employee to improve and/or gain additional knowledge, skills, and abilities
to perform their current job. As an option, a supervisor is encouraged to document opportunities that would help an employee
enhance his/her performance in the current job or allow an employee to make a greater contribution to the department/office.

SECTION A: - Knowledge, skills and abilities that would enhance the employee’s current performance:

SECTION B: - Training and Education opportunities that would help the employee to gain the knowledge. Skills, and abilities
cited in Section A. (The employee should be aware that the department’s ability to offer training and education opportunities is
contingent on the availability of funds, the workload of the department, and University and State policies governing training and
education requests):

Reviewer Comments and Signature


Ensure that the employee and supervisor mutually developed performance expectations (Work Plan). If the appraisal reflects
substantial disagreement regarding the employee’s performance, attempt to mediate the differences by meeting with the
employee and the supervisor. If the differences are not mutually resolved, the Department/Office Head (if other than the
Reviewer) should be given an opportunity to resolve the differences. Provide a written response to the employee if requested.

Employee’s Signature:_____________________________________________ Date:______________________

Supervisor’s Signature:____________________________________________ Date:______________________

Reviewer Signature ______________________________________________ Date ______________________

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