Performance Appraisal – Employee Self Appraisal

Looking back over the past year, please rate yourself in these categories (on a scale of 1-5 with 5 being the best).

Statements:	1	2	3	4	5
1.       Professional Knowledge – I have a good understanding of my professional discipline and job responsibilities.
2.  Quality of Work – I am thorough & accurate.
3.       Quantity of Work – I accomplish the correct amount of work for this position.
4.    Dependability – I am dependable, reliable and timely in my work.
5.       Planning & Organization – I establish priorities, and set goals and objectives.
6.       Initiative/Problem Solving – I show initiative and independent action, when appropriate, when problem solving or developing solutions.
7. Cooperation – I work effectively with associates.
8.       Attitude – I show enthusiasm, interest, and commitment to the company and my position.
9.       Communication Skills – I have the ability to effectively receive and convey information, both verbally & in written form.
10.     Interpersonal Skills – I have the ability to develop working relationships with my peers.
11.     Professional Behavior – I project a positive image of myself and the company.
12.     Self-Improvement – I am consistently learning & improving job skills and personal growth skills.

Please answer the following questions looking back over this past year.

1. Please list three things you have done well on your job during the past year which showed initiative and problem solving skills.

• ____________________________________________________________________
• ____________________________________________________________________
• ____________________________________________________________________

2. What have you enjoyed the most about your job this year?

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3. Give a specific example of an interaction with a coworker where you showed cooperation and interpersonal skills.

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4. In your relationship with your supervisor, what could your supervisor do differently to motivate you? Please be as specific as possible.

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________________________________________________________   _____/_____/_____

         Employee Signature                                                                  Date

________________________________________________________   _____/_____/_____

      Supervisor/Manager Signature                                             Date

This document is to be attached to performance review from Supervisor/Manager and filed in employee’s personnel file.