RATED EMPLOYEE IDENTIFICATION
Name of Employee (Last, First, MI) Click here to enter text.	Personnel Number Click here to enter text.	Agency Number Click here to enter text.
Position Title Click here to enter text.	Class Code Click here to enter text.	Position Number Click here to enter text.

WORK ASSESSMENT
Provide specific comments to each of the following as your personal assessment of your work for this review year.
Areas of good or exceptional work specific to the position description. Click here to enter text.
Challenges to improve during the upcoming year to enhance your area or professional abilities. Click here to enter text.

GOALS
Goals from last review year and actions taken. Click here to enter text.
Position Specific Goals for the Upcoming Year. Click here to enter text.
Professional Development Goals for the Upcoming Year. Click here to enter text.

PROFESSIONAL DEVELOPMENT
List all professional development accomplished this review period. Click here to enter text.

COLLEGE AND COMMUNITY SERVICE
All employees are encouraged to participate in some form of College service. Examples include various drives and festivals, special events and ..other activities that support student learning and College-related community engagement. Please provide a list of College activities that you ..volunteered for, or participated in, during the reporting period. Click here to enter text.

The following sections to be completed by the Direct Supervisor.
RELIABILITY RELATIVE IMPORTANCE: [☐] A [☐] B [☐] C
Attendance, Dependability, Tardiness
Comments: Click here to enter text.
Performance Rating: [☐] Exceeds Standards [☐] Above Average [☐] Satisfactory [☐] Unsatisfactory

WORKS EFFECTIVELY WITH OTHERS / DEMONSTRATED LEADERSHIP RELATIVE IMPORTANCE: [☐] A [☐] B [☐] C
Willingness to assist others, ability to communicate clearly and demonstrated sound decision-making ability. Effectiveness in leadership roles and responsibilities as appropriate to your position.
Comments: Click here to enter text.
Performance Rating: [☐] Exceeds Standards [☐] Above Average [☐] Satisfactory [☐] Unsatisfactory

EFFICIENT AND EFFECTIVE USE OF RESOURCES RELATIVE IMPORTANCE: [☐] A [☐] B [☐] C
Proper use of budgets, time and training opportunities.
Comments: Click here to enter text.
Performance Rating: [☐] Exceeds Standards [☐] Above Average [☐] Satisfactory [☐] Unsatisfactory

INITIATIVE RELATIVE IMPORTANCE: [☐] A [☐] B [☐] C
Drive to do a better job, seeks opportunities to improve and learn. Accomplish tasks and projects with minimal outside direction or guidance.
Comments: Click here to enter text.
Performance Rating: [☐] Exceeds Standards [☐] Above Average [☐] Satisfactory [☐] Unsatisfactory

JOB KNOWLEDGE AND SKILLS RELATIVE IMPORTANCE: [☐] A [☐] B [☐] C
Degree of technical knowledge, understanding of job procedures and methods.
Comments: Click here to enter text.
Performance Rating: [☐] Exceeds Standards [☐] Above Average [☐] Satisfactory [☐] Unsatisfactory

QUALITY OF WORK RELATIVE IMPORTANCE: [☐] A [☐] B [☐] C
Competence, accuracy, neatness, thoroughness, volume of work accomplished, ability to meet deadlines, productivity levels.
Comments: Click here to enter text.
Performance Rating: [☐] Exceeds Standards [☐] Above Average [☐] Satisfactory [☐] Unsatisfactory
CUSTOMER SERVICE RELATIVE IMPORTANCE: [☐] A [☐] B [☐] C
Provides friendly, supportive, efficient and effective service to students, other clients, co-workers and supervisor.
Comments: Click here to enter text.
Performance Rating: [☐] Exceeds Standards [☐] Above Average [☐] Satisfactory [☐] Unsatisfactory

FLEXIBILITY/ACCEPTANCE OF CHANGE RELATIVE IMPORTANCE: [☐] A [☐] B [☐] C
Participates in cross-training opportunities, willingness to adapt to needed College, departmental or position function changes, willingness to adapt to changes in schedules.
Comments: Click here to enter text.
Performance Rating: [☐] Exceeds Standards [☐] Above Average [☐] Satisfactory [☐] Unsatisfactory

IMPROVEMENT SUGGESTIONS / GOAL
State any improvement suggestions and specific goals for improvement discussed with the employee, including appropriate timeline for the goals to be completed.
Comments: Click here to enter text.

SUPERVISOR REMARKS
Remarks: Click here to enter text.

PERFORMANCE STANDARDS AGREEMENT
The Employee: [☐] Has [☐] Has Not received a written or greater conduct related reprimand during the rating period.
I have reviewed the performance standards and understand that my performance will be measured against them. Please initial. _____ I agree with this review. _____ I do not agree with this review. Additional documentation should be added to clarify if the employee disagrees with review.

OVERALL RATING
It is understood that an Unsatisfactory in any of the above fields precludes awarding in Exceeds Standards or Above Average rating during the rating period. The overall rating received is determined at the discretion of the rater.
Performance Rating: [☐] Exceeds Standards [☐] Above Average [☐] Satisfactory [☐] Unsatisfactory

Employee’s Signature	Date
Direct Supervisor’s Name: Click here to enter text.
Direct Supervisor’s Signature	Date
Department Supervisor’s Name: Click here to enter text.
Department Supervisor’s Signature	Date