Your Name
Your Email
date
br>
Knowledge of job required for position: (required)
OutstandingVery GoodGoodBelow AverageUnsatisfactory
Ability to produce high quality work in a timely and efficient manner: (required)
Takes responsibility for assigned work: (required)
Uses good judgment in decision making: (required)
Ability to make on job decisions: (required)
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)
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)
My overall attitude in the work place is: (required)
My ability to communicate in a friendly, courteous manner towards others in the workplace is: (required)
I am aware of the impact that my behavior may have on others: (required)
I maintain a positive attitude while preforming tasks: (required)
I am adaptable to new people, new situations, new information and new developments: (required)
How much did you improve since your last evaluation?
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)
Punctuality: (required)
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)
12345678910