Initial Review Period Performance Evaluation Page 3

Employee Name:

Based on this employee’s job performance and conduct during the initial review period, I

recommend the following:

Retain employee

Discharge employee (Requires prior approval of Director of Human Resources)

(See Note)

Extend initial review period

Note

This option will only be used in specific instances when supervisor has not had

sufficient opportunity to evaluate the employee’s job performance (e.g., extended

absence of either employee or supervisor, significant change in job duties, etc.)

Extension of initial review period requires prior Human Resources approval.

Supervisor’s Signature:

Date:

Employee’s Signature:

Date:

EMPLOYEE’S COMMENTS:

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Parent category: Business