SELF-EVALUATION WORKSHEET
Name:
Date:
Employee ID:
Department:
Position:
Supervisor:
WHAT I’VE DONE
SUCCESSES:
Inspirational Questions: What work did I enjoy the most? What makes me most proud?
What projects did I lead? What relationships did I build?
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Suggested section length: 3 to 5 bullets
KNOWLEDGE GAINED:
Inspirational Questions: What trainings did I complete? What professional organization
events did I attend? What changed this year that allowed for a learning opportunity?
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Suggested section length: 3 to 5 bullets
CHALLENGES:
Inspirational Questions: What kept me up at night? What do I wish I had the chance to redo? What was the most difficult thing I faced at work this year?
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Suggested section length: 2 to 3 bullets
Tips: How to Write It
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Use measurable objectives to communicate your impact
State your value and provide factual evidence to support your accomplishments
Focus on your personal performance and contributions
Use developmental language when communicating areas to improve
WHAT I PLAN TO DO
Inspirational Questions: Where do you think your skills can make the most impact? Is there
an area that needs to be improved that I could make a positive impact? Is there I best practice I
can share?
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Suggested section length: 3 bullets
WHAT I NEED
Inspirational Questions: Is there a stretch project that I can request to build my skills? Is
there a training or developmental opportunity that would maximize my impact? Is there an
obstacle to my effectiveness that I need support to remove?
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Suggested section length: 2 to 3 bullets