Employee: 

                                                         Date of Review:                  

 
From:                              To:       

 
Department:                                                       Job Title:                   

 
OVERALL EVALUATION SUMMARY:

 
Essential Job Functions & Responsibilities:

Job Description has been reviewed (and updated, if needed): Yes ______ No_________

 
Accomplishments
Please list this individual’s top accomplishments this year.

 
Strengths

Please list this individual’s strengths, and after each, give a specific example of an
instance where this strength was exemplified. 

 
Opportunities for Improvement

Please list any areas where this individual could improve and develop performance.

 
 

 
CHECK ONE:

______Meets or exceeds job requirements   

______Needs improvement to meet job requirements as listed:

_______________________________________________________________________ 

_______________________________________________________________________

Significant improvement needed to meet job requirements as listed:

_______________________________________________________________________

_______________________________________________________________________

 
Overall Development Plan (include optional training, if applicable, and goals).

 
 

 
Required Training (include training that is mandatory and must be completed by the
next review cycle).

 
______Check here if no training is required for the next evaluation cycle

 Date :____________________________ Employee Signature :____________________ 

Date :____________________________ Supervisor Signature:____________________  

EMPLOYEE COMMENTS (Optional):