Performance Appraisal Self Assessment

Employee Name: ______________________________ Date: __________

Job Title: _________________________ Location: ___________________

Supervisor's Name: _____________________________________________

Performance Review Period: _____________________________________

Employee Instructions:
Please complete and return this self-evaluation to your supervisor by [date].
Your thorough and timely participation in the appraisal process will help facilitate a fair and comprehensive review of your progress and accomplishments since the last performance review. If you have been employed by the company less than a year, substitute references to "since the last performance appraisal/review" with "since you were hired" and answer the questions accordingly.

1.     List your most significant accomplishments or contributions since last year. How do these achievements align with the goals/objectives outlined in your last review?

2.     Since the last appraisal period, have you successfully performed any new tasks or additional duties outside the scope of your regular responsibilities? If so, please specify.

3.     What activities have you initiated, or actively participated in, to encourage camaraderie and teamwork within your group and/or office? What was the result?

4.     Describe your professional development activities since last year, such as offsite seminars/classes (specify if self-directed or required by your supervisor), onsite training, peer training, management coaching or mentoring, on-the-job experience, exposure to challenging projects, other—please describe.

5.     Describe areas you feel require improvement in terms of your professional capabilities. List the steps you plan to take and/or the resources you need to accomplish this.

6.     Identify two career goals for the coming year and indicate how you plan to accomplish them.

7.     Evaluate yourself on all factors that apply to you since your last performance appraisal, or date of hire if employed here less than one year. If a category does not apply to you, indicate N/A.

Rating Scale:      4 - Outstanding/Role Model          3 - Very Competent
                             2 - Satisfactory                              1 - Inexperienced or Improvement Needed

8.     Name any other management personnel, besides your current supervisor, that you feel should provide input toward your performance appraisal.

Thank you for taking the time to complete the Employee Self-Assessment.

Supervisors: Attach completed Self-Assessments to the Employee's Performance Appraisal and return to HR.