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Employee Self Assessment Form

Employee Information
Name: Department:
Position: Date:
Current Responsibilities
List of key responsibilities

Assess your performance in relation to your key responsibilities

Performance goals
List your performance and work objectives

Assess your performance in regards to your previously set of performance and objectives

For improvements
What do you consider your weaknesses and how will you turn them into your strength

HR Representative:
Review Period:
Date of Review: Employee Signature:

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