Suggestions & Comments to:
Barbara Weldon

Human Resources

Since this document needs to be filled out by supervisors and appraisees, this document is being provided in 3 formats.

  1. Word 97 format
  2. Adobe PDF format - (not editable, but useful for printing)
  3. HTML (below) - copy/paste it into your wordprocessing program and format

P4P/SCP Program
RUL Self-Assessment Form

Parts I & II are to be completed by the supervisor who is conducting the performance appraisal.
Parts III & IV to be completed by the appraisee.

Supervisor Completes:
Part I: Duties & Responsibilities
Key duties are based on the position description and mutual agreement with the employee. Please list the key duties in order of importance.

Part II: Performance Standards
Please list the standards for the Meets Standards level of performance as developed during the performance planning meeting. Each key duty listed above must have a corresponding standard.

Employee (Appraisee) Completes:
Part III. Overall Assessment
Please assess your performance by giving yourself a rating for each duty and an overall assessment rating.

Meets standards [MS]
Does Not Meet Standards [DNM]

1.   					4. 
2.  					5.

Overall Assessment

Part IV: Support for Appraisal
Please provide support and/or documentation for your assessment. Attach an additional sheet if necessary. You may wish to consider the following questions as you work through this process:

  1. What were my significant achievements this year?

  2. Did I meet with my supervisor to discuss performance expectations?

  3. Have my responsibilities changed significantly during the appraisal period?

  4. If my responsibilities have changed, were the performance expectations revised?

  5. Did I meet my performance expectations? Provide examples

  6. Did I exceed my performance expectations? Provide examples

  7. Was I unable to meet the expectations? Provide reason

  8. Do I have responsibilities that were not included in the performance expectations?

Last updated March 9, 2005; April 26, 2010; April 4, 2012
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