Performance Evaluation Form Page 4
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4Last Name: _______________________
Last Four of SSN: __________________
Overall Rating
0.00
Add up all TOTAL RATING scores to determine the OVERALL RATING:
Supervisor Comments:
Employee Comments:
Attachments:
Self-Evaluation
Performance Improvement Plan*
*A rating of 1 or 2 for any Essential Function requires the completion of a Performance Improvement Plan by the supervisor and the employee.
Attach a copy of Sections One and Two of the Performance Improvement Plan to this Performance Evaluation Form and forward to Human
Resources.
**
Employee Signature: _____________________________________________________________
Date: _____/_____/______
Immediate Supervisor Signature: ____________________________________________________
Date: _____/_____/______
Next Level Supervisor Signature: ____________________________________________________
Date: _____/_____/______
Note: When the Performance Evaluation form is completed and signed, provide a copy to the employee, retain a copy for
department file, and send original to Human Resources Records, Room 21 Scovell Hall, 0064.
** Employee’s signature does not eliminate the right to address questions or concerns about the content of the evaluation through the appropriate departmental chain of
command.
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Parent category: Business