Your Name

Your Email

date

Job Components

Knowledge of job required for position: (required)

OutstandingVery GoodGoodBelow AverageUnsatisfactory

Ability to produce high quality work in a timely and efficient manner:
(required)

OutstandingVery GoodGoodBelow AverageUnsatisfactory

Takes responsibility for assigned work: (required)

OutstandingVery GoodGoodBelow AverageUnsatisfactory

Uses good judgment in decision making: (required)

OutstandingVery GoodGoodBelow AverageUnsatisfactory

Ability to make on job decisions: (required)

OutstandingVery GoodGoodBelow AverageUnsatisfactory

What is the toughest part of your job? (please explain; required)

What areas of your job do you not enjoy? (please explain; required)

Please list the best attributes you apply to the company: (please explain; required)

Goals & Professional Development

What role do you want in the company over the next 3 years? (please explain; required)

What are you actively doing to help achieve these goals? (please explain; required)

What resources can the company do to help you achieve these goals? (please explain; required)

What goals did you accomplish since your last evaluation? (please explain if applicable)

What goals were you unable to accomplish and what hindered you from achieving them? (please explain if applicable)

What personal goals do you hope to achieve within 3 years? (please explain; required)

My biggest day to day challenge with the company is? (please explain; required)

I actively recognize and act on opportunities for improvement: (required)

OutstandingVery GoodGoodBelow AverageUnsatisfactory

Communication & Leadership

My overall attitude in the work place is: (required)

OutstandingVery GoodGoodBelow AverageUnsatisfactory

My ability to communicate in a friendly, courteous manner towards others in the workplace is: (required)

OutstandingVery GoodGoodBelow AverageUnsatisfactory

I am aware of the impact that my behavior may have on others: (required)

OutstandingVery GoodGoodBelow AverageUnsatisfactory

I maintain a positive attitude while preforming tasks: (required)

OutstandingVery GoodGoodBelow AverageUnsatisfactory

I am adaptable to new people, new situations, new information and new developments: (required)

OutstandingVery GoodGoodBelow AverageUnsatisfactory

How much did you improve since your last evaluation?

OutstandingVery GoodGoodBelow AverageUnsatisfactory

What changes did you make to help make improvements? (please explain)

I am easy to approach and consistently treat everyone with dignity, respect and fairness: (required)

OutstandingVery GoodGoodBelow AverageUnsatisfactory

Punctuality: (required)

OutstandingVery GoodGoodBelow AverageUnsatisfactory

Based on YOUR personal satisfaction with your job (workload, environment, pay, challenge, etc.), how would you rate your satisfaction from 1 poor to 10 excellent? (required)

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