| Name: | ____________________ | | | | | Title: | ____________________ | Department/Location: | ____________________ | | Date: | ____________________ | Supervisor's Name: | ____________________ | | Please type or print your responses. If necessary, attach additional pages. |
Use the following scale to reply to each question:
A = Consistently Fulfills and Exceeds Duties B = Fulfills and Frequently Exceeds Duties C = Fulfills Duties D = Sometimes Fulfills Duties F = Rarely Fulfills Duties For any mark of "D" or "F" given, a written explanation must accompany it. |
I. PERFORMANCE QUALITY: _______ Regarding Volume Produced _______ Regarding Job Accuracy COMMENTS: | | II. INTERPERSONAL SKILLS: How well does this employee get along with: | | _______ Subordinates | _______ Co-Workers | | | | _______ Supervisors | _______ Contacts Outside the Company | | | COMMENTS: | | III. INDEPENDENCE: | | _______ Ability to work on his or her own COMMENTS: | | IV. RELIABILITY: _______ Regarding completion of projects _______ Regarding attendance COMMENTS: | | V. BACKGROUND AND JOB REQUIREMENTS: _______ Formal Education _______ Background Experience _______ Technical Skills COMMENTS: | | VI. PLEASE GIVE AN OVERALL MARK FOR EMPLOYEE AND EXPLAIN SAME BELOW: _____ Overall Mark OVERALL COMMENTS: | | | PREPARED BY: | APPROVED BY: | ____________________ Name and Title | ____________________ Name and Title Of Supervisor | ____________________ Signature | ____________________ Signature Of Supervisor | ____________________ Date | ____________________ Date |
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Copyright 1998 Steven M. Sack