Fillable Printable Performance Appraisal Form Sample

Performance Appraisal Form Sample

Form 235

V20110824

Please return completed form to the Human Resources Department

6720-A Rockledge Drive · Suite 100 · Bethesda, Maryland 20817 · Telephone: (240) 694-4008 · Fax: (240) 694-3145 · www.hjf.org

PERFORMANCE APPRAISAL FORM

Review Period: to

Employee Name: Job Title:

Supervisor/Evaluator Name:

Reviewer Name:

Instructions

The purpose of this performance appraisal is to encourage employee development. It will be used to evaluate merit pay,

opportunities for advancement and staff training and development. It is important to consider the employee’s level of

demonstrated performance during the specified review period and how it relates to the definitions of performance ratings,

as well as the degree of applicability to the job. Definitions for Performance Ratings and Importance to Job are provided

below. In each case, select the performance rating that most closely describes the employee’s performance. If an

employee earns a rating of Excellent, Needs Improvement, or Unsatisfactory, the Comments section must be completed.

Definitions of Performance Rating

(5) Excellent: Performance consistently far exceeds normal job requirements.

(4) Exceeds Expectations: Performance consistently exceeds normal job requirements.

(3) Meets Expectations: Performance meets job requirements.

(2) Needs Improvement: Performance does not meet job requirements; minor performance deficiencies.

(1) Unsatisfactory: Performance fails to meet job requirements; major performance deficiencies.

Definitions of Applicability to Job

(A) Very Important: Essential to the performance of the job.

(B) Important: Significant in the performance of the job.

(D) Not Applicable: Not required in the performance of the job.

HJF Form 235

V20110824

Please return completed form to the Human Resources Department

6720-A Rockledge Drive · Suite 100 · Bethesda, Maryland 20817 · Telephone: (240) 694-4008 · Fax: (240) 694-3145 · www.hjf.org

Page 2 of 3

Performance Factors

Applicability to

Job (A-D)

Excellent

Exceeds

Expectations

Meets

Expectations

Needs

Improvement

Unsatisfactory

1. Professional Knowledge – Applies technical or professional

competency to work situations.

5 4 3 2 1

2. Quality of Work – Applies job knowledge effectively and thoroughly.

Demonstrates reliability and accuracy in work performance.

5 4 3 2 1

3. Initiative – Identifies and resolves problems without prompting. 5 4 3 2 1

4. Innovation/Creativity – Develops and implements new solutions,

new procedures, concepts and designs and/or new applications of

existing designs or procedures, demonstrating imagination and

originality.

5 4 3 2 1

5. Judgment – Makes well-reasoned and sound decisions, accurately

interprets events and develops appropriate courses of action.

5 4 3 2 1

6. Planning/Organization – Organizes time and resources effectively

to achieve goals; sets appropriate priorities.

5 4 3 2 1

7. Dependability – Meets schedules consistently including deadlines

and project requirements.

5 4 3 2 1

8. Written Communications – Writes concise, organized and clear

communications that meet appropriate objectives.

5 4 3 2 1

9. Oral Communications – Conveys ideas persuasively, either speaking

ad hoc or in a prepared presentation.

5 4 3 2 1

10. Team Building – Cooperates with and supports others within the

department and in other departments; works effectively with others to

achieve Foundation goals.

5 4 3 2 1

11. Productivity/Quantity of Work – Volume of work done in relation

to the job performed.

5 4 3 2 1

12. Customer Service – Procedures and attitude that effect external and

internal customers.

5 4 3 2 1

The section below is reserved for appraising/evaluating supervisory personnel only.

Please complete numbers 13-16 if applicable.

13. Leadership – Guides a group or an individual toward task

accomplishment. Effective in getting work accomplished through

others.

5 4 3 2 1

14. Development of Self and Staff – Coaches, counsels, and provides

on-the-job development of staff; encourages career development;

targets areas for own professional growth.

5 4 3 2 1

15. Supervision – Directs personnel in a way that generates respect,

loyalty and enthusiasm; is eager to enable staff to achieve successes;

delegates effectively.

5 4 3 2 1

16. Affirmative Action – Takes affirmative action in recruiting, hiring

and promoting employees.

5 4 3 2 1

HJF Form 235

V20110824

Please return completed form to the Human Resources Department

6720-A Rockledge Drive · Suite 100 · Bethesda, Maryland 20817 · Telephone: (240) 694-4008 · Fax: (240) 694-3145 · www.hjf.org

Page 3 of 3

Strengths and Areas for Development (If more space is needed, please attach additional sheets.)

1. Identify employee’s strengths in the work place.

2. Identify areas in which the employee could further develop performance.

3. Identify goals and objectives for performance and development during the next 12 months.

Based on all previous measures of performance, the overall performance rating is:

Excellent Exceeds Expectations Meets Expectations Needs Improvement Unsatisfactory

Signatures

In signing this form, the employee acknowledges that this appraisal has been reviewed with him/her and

understands the supervisor’s expectations and comments.

I do not agree with appraisal (attach explanation if desired)

Employee Signature: __________________________________________ Date: __________________

Supervisor/Evaluator Signature: __________________________________ Date: __________________

Reviewer Signature: ____________________________________________ Date: __________________

HJF Official’s Signature: _________________________________________ Date: __________________

(Required if evaluator and reviewer are not employees of HJF.)

Supervisor/Evaluator/Reviewer Comments (optional)

(If more space is needed, please use back of page.)