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PERFORMANCE EVALUATION FORM 2016
Code 104/114 Technical Staff and Code 106/116 Clerical Staff
Employee Name
Job Title
Department
Supervisor
Appraisal Period
4/1/15 through 3/31/16
Date of Appraisal
I. PERFORMANCE FACTOR RATINGS Using the following definitions check the box that most closely
describes the employee’s performance for each of the required performance factors.
FAR EXCEEDS: Outstanding performance that always exceeds expectations, demonstrated for an extended,
sustainable period of time.
SURPASSES: Very strong performance that exceeds expectations in most situations, and meets expectations in
all others.
SUCCESSFULLY MEETS: Consistently strong performance, always meets expectations, occasionally exceeds
expectations.
PARTIALLY MEETS: Indicates good but inconsistent performance, meeting some, but not all job requirements or
expectations.
DOES NOT MEET: Major gaps in performance against job requirements or expectations. Immediate and
substantial improvements must be made.
PERFORMANCE FACTORS
FAR
EXCEEDS
SURPASSES
SUCCESSFULLY
MEETS
PARTIALLY
MEETS
DOES
NOT
MEET
QUALITY OF WORK
Consider accuracy, thoroughness,
effectiveness.
FLEXIBILITY
Consider performance under
pressure and handling of multiple
assignments.
INITIATIVE
Consider the extent to which the
employee seeks opportunities to be
proactive and to create solutions.