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EMPLOYEE NAME : POSITION : DATE :

POOR FAIR SATIFACTORY SATISFACTORY PLUS GOOD VERY GOOD
0 40 50 60 70 85 100

ITEM EVALUATED	ITEM WEIGHED	SUB-ITEM WEIGHED	PREVIEWED BY		SUB-ITEM SCORE	ITEM SCORE
ITEM EVALUATED	ITEM WEIGHED	SUB-ITEM WEIGHED		FIANL	SUB-ITEM SCORE	ITEM SCORE
1. BUSINESS PERFORMANCE	50%
OBJECTIVES ACHIEVED		40%
QUALITY OF ACOMPLISHMENTS		30%
COST CONTROL		30%
2. CAPABILITIES	25%
PROFESSIENCY		40%
LEADERSHIP		20%
PLANNING		20%
JUDGEMENT		20%
3.SERVICES	25%
ADMINISTRATION		20%
RESPONSIBLE		20%
RELIABLE		20%
LOYALITY TO COMPANY		20%
LOYALITY TO SUPERVISOR		10%
PARTICIPATION		10%
4. OVERALL SCORE :
5. OVERALL ASSESSMENT :
6. ATTENDANCE DEDUCTION :
7. DISCIPLINE DEDUCTION/ADDITION :
8. FINAL SCORE :
9. FINAL ASSESSMENT :
10. COMMENTS :

REVIEWED BY :

ACKNOWLEDGED BY :

IMMEDIATE SUPERVISOE HIGHER SUPERVISOR EMPLOYEE

EMPLOYEE :

POSITION :                                                    DATE TO :
                                                                     POSITION :
SUBSIDIARY :                                                 LOCATION :

ANALYSIS OF CURRENT PERFORMANCE

ACCOMPLISHMENTS :

USED OBJECTIVES :

SIGNIFICANT PERSONAL AND PERFORMANCE CHARACTERISTICS

WHICH HELPED ACCOMPLISHMENTS

WHICH, IF USED, MIGHT HAVE ENHANCED

ACCOMPLISHMENTS

SUMMARY STATEMENT OF HOW OVERALL PERFORMANCE (ACCOMPLISHMENTS)
COMPARED WITH EXPECTATIONS :

PLAN FOR COMING YEAR
OBJECTIVES :
OBSTACLES TO ACHIEVING OBJECTIVES AND ACTIONS WHICH COULD HELP OVER THEM:

PERSONAL DEVELOPMENT PLANS
PERSONAL CHARATERISTIC KNOWLEDGE,SKILL, INDIVIDUAL FACTOR	ACTION PLANS TO ACCOMPLISHMENT DEVELOPMENT (WHAT, HOW, WHOM, WHERE, ETC)	WHEN

COMMENTS/OTHER DISCUSSION ITEMS :

EMPLOYEE/DATE : SUPERVISOR/DATE :