Employee Self-Assessment Form |
Employee Name (Last, First, Middle) |
Employee ID Number |
| Role Title and/or Working Title |
Position Number Position Suffix |
Supervisor’s Name |
List your work related accomplishments and/or contributions for this performance cycle. Including any training/developmental classes, projects, completed assignments, and anything else that you think should be included. |
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| What areas of your performance have you been most successful? |
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| Are there any aspects of your work where you have not done as well as hoped and why? (Give examples). What things could be done to improve on these aspects on your part, your supervisor’s, and the department/organization? |
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| List any training and/or developmental activities that would help you improve your work performance or enhance your career objectives. |
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| List a particular goal/achievement(s) you would like to complete in the next performance year. What guidelines have you set up to accomplish these and how can your supervisor and the department assist you in achieving these goals? |
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| Does your current Employee Work Profile accurately reflect the duties of your position? If not how does it need to be amended? |
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| Comments |
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| Supervisor’s Signature: |
Date: |
| Employee’s Signature: |
Date: |