Date: Attendance: Quality of Work: Quantity of Work: Learns

NAME:
DATE:
DEPT:
Annual Evaluation
Date:
Attendance:
Quality of Work:
Good
Satisfactory
*Needs Improvement
1
1
1
WORK CHARACTERISTICS
Quantity of Work:
Good
1
Satisfactory
1
*Needs Improvement
1
Learns:
Good
Satisfactory
*Needs Improvement
1
1
1
*Give specific examples of behavior:
*Give specific examples of behavior:
*Give specific examples of behavior:
Needs Supervision:
Safety Habits:
Attitude toward work:
Good
1
Satisfactory
1
*Needs Improvement
1
*Give specific examples of behavior:
Good
Satisfactory
*Needs Improvement
1
1
1
1
1
1
Good
Satisfactory
*Needs Improvement
*Give specific examples of behavior:
*Give specific examples of behavior:
Attendance:
Productivity:
Good
Satisfactory
*Needs Improvement
1
1
1
*Give specific examples of behavior:
1
1
1
Good
Satisfactory
*Needs Improvement
*Give specific examples of behavior:
Gets along with Others:
Good
Satisfactory
*Needs Improvement
1
1
1
*Give specific examples of behavior:
Check Which Apply:
Cooperative
*Uncooperative
1
1
*Give specific examples of behavior:
*Give specific examples of behavior:
Are you satisfied to have this employee in your service? YES 1
If not suitable, do you recommend a transfer or discharge? Why?
What can be done by the employee to improve performance?
Comments:
Employee Signature
Supervisor's Signature
Date
Revised 12/2012
1
1
Pleasant
*Temperamental
NO 1
*Temperamental
1
*Give specific examples of behavior:

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