Employee Self-Assessment Form

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DHRM August 2001
Employee Self-Assessment Form
Employee Name:
Supervisor Name:
*Rating
Core Responsibilities - Comments on Results Achieved
Extraordinary
A.
Contributor
Contributor
Below Contributor
Extraordinary
B.
Contributor
Contributor
Below Contributor
Extraordinary
C.
Contributor
Contributor
Below Contributor
Extraordinary
D.
Contributor
Contributor
Below Contributor
Extraordinary
E.
Contributor
Contributor
Below Contributor
Extraordinary
F.
Contributor
Contributor
Below Contributor
* See Ratings definitions on page 3.
Employee Self-Assessment
Page 1

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