EMPLOYEE PLANNING AND PERFORMANCE REVIEW FORM

‫ذج ا ا  وأداء ا‬

Employee
Name: Employee ID:

‫ا ا‬
‫ر ا‬

Classification: Department:
‫ا!ی‬/ ‫اﺕ‬ ‫ة‬#‫ا‬$‫ا‬

Type of Review (Please check one box. Temporary employees receive annual or additional reviews only.)
./ 0/12‫ي أو إ‬5  .‫)ن *)( ﺕ‬78‫ ی‬9 :‫ ا‬9 ;‫ – ا‬$%‫  *)( ﺏ& وا‬+,‫ ی( ا‬،‫ع اا‬
1st Probationary/ ‫  ا@ول‬.‫ ا‬/‫ر‬1!‫ا>ﺥ‬/< ;‫ا‬
nd
2 Probationary 01A‫  ا‬.‫ ا‬/‫ر‬1!‫ا>ﺥ‬/< ;‫ا‬
3rd Probationary B1A‫  ا‬.‫ ا‬/‫ر‬1!‫ا>ﺥ‬/< ;‫ا‬
Additional Reason: ‫ب أﺥى‬1!‫ا‬
st th
Annual (Annual Reviews reflect performance from July 1 – June 30 of each fiscal year.)
‫ي‬5 ( 1‫ ا‬5H‫یان ا‬J% 30 (%‫ ﺕز و‬01 9
‫ ا‬1% FG‫ی ﺕ‬5H‫)اا ا‬

Review Period ‫ة اا‬/

(‫ا‬ 5/L+ 9 5/L+
From To
Month/Year Month/Year

 ‫ وآ  اهاف ا‬،‫"!  وأداء ا‬#‫ذج ﻡا ا‬ 0/  1‫اء ا‬J@‫ ا‬M‫أآ‬

Complete the following sections of the Employee Planning and Performance Review Form as well as the Goal Setting Sheet.
PLEASE NOTE: :)‫ﺡ‬+‫ی' ﻡ‬

• Before completing this form with the employee being (‫ ی‬،Q .‫ي ی ﺕ‬R‫ذج & ا
ا‬5‫ا ا‬R‫ل ه‬1‫ إآ‬M! -
reviewed, please discuss and review it with your ‫ت‬1$‫ة ا‬#‫ی دا‬$ &  .‫ وا ا‬U15
Administrative Services Manager (ASM).

• Issues of attendance, reliability, dependability, etc. should Z‫ ی‬..V‫  ا‬W.>‫دی وا‬1*>‫ وا‬،‫ر‬X8‫ت ا‬1*2 -
be addressed in Section IV, Item B. .(‫ )ب‬$5!‫ ااﺏ& – ا‬H.‫ ا‬0/ 1L ‫اق ا‬
• Any questions or concerns regarding the performance (‫ ا‬Q‫ أن ﺕ‬Z‫ل إاءات ا ا@داء ی‬% ‫رات‬1H;‫ اي ا‬-
review process should be directed to your ASM or Benefits .‫ی‬U!‫در ا‬17‫ وا‬1‫ای‬J‫ ا‬0; ‫ أو‬،‫ت‬1$‫ة ا‬#‫ی دا‬$
and Staff Human Resources.

1 Revised 6/09
 SECTION I ‫ ا@ول‬H.‫ا‬
REQUIRED CRITERIA ‫ی  ا)ﺏ‬1‫ ا‬/\#17‫ا‬
‫!ل‬.‫  ا‬a‫ و‬Q‫ى ﺏ‬$8‫ي ی‬R‫ذج ا‬5‫یات ا‬$.‫ ﺕ‬9 MG ‫ری‬1!‫دة إ‬$‫) ا‬A@‫ ا‬.]/ M‫ آ‬0/ ^ .‫* ﺕ‬$ ‫دة‬$8 ‫) )ك‬A‫م أ‬$‫)ا‬
(Use specific behavioral examples to support ratings in every category. Specific examples are mandatory
for both exemplary and unacceptable ratings.)
:. 4 12# ‫  – أه‬. ‫رات ا‬12‫ ا‬-1
1. JOB SKILLS - Importance to Position  1‫ ا‬Critical ‫ا‬$ 1‫ ه‬Very Important 1‫ ه‬Important
.1L 0; ‫ اﺹ
ا‬0/ MZH ‫ ه‬1‫ ا ; آ‬cRL  ; ‫م ا‬1L‫دی ا‬, ‫رات ا)ﺏ‬$.‫ا*! ا‬
Consider the ability needed to perform the major responsibilities of this job as noted in the position description.

Q‫ى ﺏ‬R8‫ی‬/0‫ذ‬ ‫ء‬15A1‫ی ﺏ‬$ 02 9 H8‫ج ﺕ‬18‫ی‬ ‫!ل‬.  a

Exemplary Commendable Satisfactory Needs Improvement Unacceptable
‫رات‬1dddL ‫ار‬ddd1‫ ﺏ‬dddLe‫ی‬ $dd‫ی‬J‫رات ﺕ‬1ddL ddLe‫ ی‬1dd!1a 0dd;‫رات ﺕ‬1ddL 1dd#‫ دا‬ddLe‫ی‬ ‫ر‬1ddL‫ ا‬9dd* JddZ‫ ی‬1dd 1dd!1a ‫ر‬1ddddL‫ ا‬9dddd* 1dddd#‫ دا‬JddddZ‫ی‬
ddd)a‫ أ‬ddd‫دی‬1‫ ﺕ‬0ddd/  #15Addd‫ا‬ ddddddd‫دی‬, ‫ب‬ddddddd)‫ ا‬9ddddddd* d‫ ه‬1d 9d* 1d1 %‫ أ‬$‫ی‬J‫ ﺕ‬$‫و‬ ddd‫دی‬, ddd‫رات ا)ﺏ‬1ddL‫ا‬ dde dd‫رات ا)ﺏ‬1ddL‫ا‬
 ; ‫ ا‬Q‫ﺕ‬1 ]H  ; ‫ت ا‬1 ]H‫ا‬ Q‫ﺕ‬1 ]dddH ddd‫دی‬, ‫ب‬ddd)  ; ‫ ا‬Q‫ﺕ‬1 ]H ،dddddddddd ; ‫ ا‬Q‫ﺕ‬1 ]ddddddddddH
 ; ‫ا‬ 51 ‫ار‬6 ‫ذ‬1"‫ب اﺕ‬4!‫ﻡ‬
Consistently Often demonstrates Regularly Often fails to Consistently fails to
demonstrates skills that exceed those demonstrates skills demonstrate skills demonstrate skills
exceptional skills in needed to perform the that meet and needed to perform the needed to perform the
performing the major major responsibilities periodically may major responsibilities major responsibilities
responsibilities of this of this job. exceed those needed of this job. of this job. Immediate
job. to perform the major action is required.
responsibilities of this
job.

Please support your rating in the narrative section below: 01‫ن ا‬1G‫ ا‬0/ ^ .‫* ﺕ‬$‫ ی‬1 ‫ح‬+ (‫ی‬

. 4 <# ‫ – أه‬9:;‫ ا‬5‫ آ  ا‬-2

2. AMOUNT OF WORK ACCOMPLISHED - Importance to Position Critical 01‫ا‬ Very Important ‫ا‬$ ‫م‬1‫ه‬
Important ‫م‬1‫ه‬
; ‫ ا‬cRL ‫اف‬$‫م وا@ه‬1L‫ی ا‬,‫ ﺏ‬h)‫ ی‬1 0/ ‫دى‬:‫ ا‬M‫ا*! آ  ا‬
Consider the amount of work performed as it relates to achieving the tasks and goals of this position.

Q‫ى ﺏ‬R8‫ی‬/0‫ذ‬ ‫ء‬15A1‫ی ﺏ‬$ 02 9 H8‫ج ﺕ‬18‫ی‬ ‫!ل‬.  a

Exemplary Commendable Satisfactory Needs Improvement Unacceptable
ddddddd ‫ار آ‬ddddddd1‫ ﺏ‬iddddddd5‫ی‬  #15Add‫ ا‬dd ‫ آ‬1dd!1a idd5‫ی‬ 9dd dd ‫ار آ‬dd1‫ ﺏ‬idd5‫ی‬ ‫ج‬1dd‫ ا‬9dd* JddZ‫ ی‬1dd 1dd!1a d ‫ج آ‬1d‫ ا‬9* 1#‫ دا‬JZ‫ی‬
cRd‫ ه‬0/ M‫ ا‬9  #15A‫ا‬ ‫ق‬ddddd;‫ي ی‬Rddddd‫ ا‬Mddddd‫ ا‬9ddddd  ‫ی‬1ddd‫ ﺏ‬0ddd;‫ي ی‬Rddd‫ ا‬Mddd‫ا‬  ‫ی‬1ddd‫ ﺏ‬0ddd;‫ي ی‬Rddd‫ ا‬Mddd‫ا‬  ‫ی‬1dd1‫ ﺏ‬0dd;‫ ﺕ‬0dd‫ ا‬Mdd‫ا‬
; ‫ا‬ ; ‫ ا‬cR‫ی  ه‬1 $dddd‫ی‬J‫ ی‬$dddd‫ و‬dddd; ‫ ا‬cRdddd‫ه‬ .; ‫ ا‬cR‫ه‬ ، dddd; ‫ ا‬cRddddL ‫دة‬$dddd8‫ا‬
11 %‫ أ‬1L5* 51 ‫ار‬6 ‫ذ‬1"‫ب اﺕ‬4!‫ﻡ‬
Consistently produces Often produces an Regularly produces an Often fails to produce Consistently fails to
an exceptional amount amount of work that is amount of work that an amount of work that produce an amount of
of work for this substantially above the meets the standards meets the standards work that meets the
position. standards for this set for this position set for this position. standards set for this
position. and periodically may position. Immediate
exceed them. action is required.

Please support your rating in the narrative section below: 01‫ن ا‬1G‫ ا‬0/ ^ .‫* ﺕ‬$‫ ی‬1 ‫ح‬+ (‫ی‬

2 Revised 6/09
 :. 4 <; ‫ أه‬:5‫ دة ا‬-3
3. QUALITY OF WORK - Importance to Position Critical 01‫ا‬ Very Important ‫ا‬$ ‫م‬1‫ه‬ Important ‫م‬1‫ه‬

‫ر‬1. M‫ ا*! ا‬.‫د‬$8‫ ا‬j‫ ا‬0/ Q‫ﺕ‬1L ‫م‬1‫دی واﺕ‬,‫ ﺕ‬0/
‫ ا‬1L!‫ ی‬0‫ت ا‬1‫ر‬$‫ وا‬،
‫ل ا‬1*‫ل أ‬1Ga‫ءة و‬1;G‫  وا‬e5‫ وا‬$‫إ*! ا‬
.M‫ن دة ا‬1X ‫اف ا)ب‬+@‫  ا‬G‫ اه ﺏ‬1X‫ ای‬.; ) ‫اف‬$‫ی  ا@داء وا@ه‬1 ‫& دة‬
Consider accuracy, organization, effectiveness, and completeness of the employee’s work. Degree to which the employee
follows through on assignments and completes them on time. Consider how the work compares to quality performance
standards and goals for the employee’s position. Also consider the amount of supervisory review required to assure work
quality.

Q‫ى ﺏ‬R8‫ی‬/0‫ذ‬ ‫ء‬15A1‫ی ﺏ‬$ 02 9 H8‫ج ﺕ‬18‫ی‬ ‫!ل‬.  a

Exemplary Commendable Satisfactory Needs Improvement Unacceptable
ddddddd ‫ار آ‬ddddddd1‫ ﺏ‬iddddddd5‫ی‬  #15Add‫ ا‬dd ‫ آ‬1dd!1a idd5‫ی‬ Mddd* ddd ‫م آ‬1ddde1‫ ﺏ‬iddd5‫ی‬ ‫ج‬1dd‫ ا‬9dd* JddZ‫ ی‬1dd 1dd!1a ‫ج‬1dd‫ ا‬9d* ‫ار‬dd1‫ ﺏ‬JdZ‫ی‬
‫ق‬dd;‫ ﺕ‬Mdd‫ ا‬9dd  #15Add‫ا‬  ‫ی‬1ddd ‫ق‬ddd;‫ ﺕ‬Mddd‫ ا‬9ddd ‫ی  ا@داء‬1dddddddddddd‫ ﺏ‬0dddddddddddd;‫ﺕ‬  ‫ی‬1ddd‫ ﺏ‬0ddd;‫ي ی‬Rddd‫ ا‬Mddd‫ا‬  ‫ی‬1ddd‫ ﺏ‬0ddd;‫ي ی‬Rddd‫ ا‬Mddd‫ا‬
‫ت‬1dddd‫ی  ا@داء وا‬1dddd cRddddddddL ‫ت‬1dddddddd‫ا@داء وا‬ 0/ ; ‫ ا‬cRL ‫ت‬1‫وا‬ cRdddd‫ ه‬9dddd ‫ت‬1dddd‫أداء وا‬ cRdddd‫ ه‬9dddd ‫ت‬1dddd‫أداء وا‬
jddd‫ ا‬0ddd/ ddd; ‫ ا‬cRdddL 15‫ ا‬j‫ ا‬0/ ; ‫ا‬ ‫ى‬H,‫ وﺏ‬15‫ ا‬j‫ا‬ 0dd/ 1dL)G‫أو > ی‬/‫ و‬d; ‫ا‬ 0dd/ 1dL)G‫أو > ی‬/‫ و‬d; ‫ا‬
9dddd ‫ر‬$dddd Mdddd,‫ ﺏ‬dddd15‫ا‬ ‫اف أو‬dd+k‫ ا‬9dd ‫ر‬$dd Mdd,‫ﺏ‬ .‫اف‬+@‫ ا‬9 15‫ا‬ ‫ج‬1ddd8‫ وی‬،ddd15‫ ا‬jddd‫ا‬ ‫ج‬1ddd8‫ وی‬،ddd15‫ ا‬jddd‫ا‬
.‫اف‬+‫ون إ‬$‫اف أو ﺏ‬+k‫ا‬ .‫اف‬+‫ون إ‬$‫ﺏ‬ ‫ى‬ddddH‫ ا‬9dddd ddddA‫( أآ‬dddd‫ا‬ ‫دي‬1ddd* ddd a ‫ى‬dddH (ddd‫ا‬
.‫اف‬+@‫ ا‬9 15‫ا‬ .‫اف‬+@‫ ا‬9
51 ‫ار‬6 ‫ذ‬1"‫ب اﺕ‬4!‫ﻡ‬
Produces exceptional Often produces work Regularly produces Often produces work Consistently fails to
work that consistently that is substantially work that meets that fails to meet produce work that
exceeds performance above performance performance performance standards meets the
standards and standards and standards and and expectations for performance standards
expectations for this expectations for this expectations for this this position and/or is and expectations for
position in a timely position in a timely position in a timely not completed in a this position and/or is
manner with minimal manner with minimal manner with the timely manner; more not completed in a
or no supervision. supervision. appropriate level of than the appropriate timely manner; an
supervision. level of supervision is unusually high level of
required. supervision is required.
Immediate action is
required.

Please support your rating in the narrative section below: 01‫ن ا‬1G‫ ا‬0/ ^ .‫* ﺕ‬$‫ ی‬1 ‫ح‬+ (‫ی‬

3 Revised 6/09
 :. 4 12# ‫ اه‬:‫درات‬1>‫ ا‬-4
4. INITIATIVE- Importance to Position Critical 01‫ا‬ Very Important ‫ا‬$ ‫م‬1‫ه‬ Important ‫م‬1‫ه‬

0/ !a‫ وا‬،M‫ت ا‬1l1U5‫درة ﺏ‬1!‫ وا‬،‫ء‬1‫ ا@ﺥ‬m 87‫ واف *)( وﺕ‬،M‫ ا)ب ا‬0/ ‫ت‬15 H8‫ ﺕ‬M* 0/ ).H ‫ل‬1*‫ذ أ‬1‫ اﺕ‬0/ !a‫إ*! ا‬
.‫ة‬#‫ا‬$‫ ا@داء ا;دي وأداء ا‬9 H8 ‫ق‬l 9* B8!‫ا‬
Consider willingness to take independent action in making improvements to work methods, identifying and correcting errors,
initiating work activities, and willingness to seek ways to improve individual and departmental job performance.

Q‫ى ﺏ‬R8‫ی‬/0‫ذ‬ ‫ء‬15A1‫ی ﺏ‬$ 02 9 H8‫ج ﺕ‬18‫ی‬ ‫!ل‬.  a

Exemplary Commendable Satisfactory Needs Improvement Unacceptable
‫ر‬1dG/‫ أ‬$d ‫ار ﺏ‬1‫م ﺏ‬.‫ی‬ ‫ءة‬1d5‫ر ﺏ‬1dG/‫ح أ‬d.‫ ی‬1d 1!1a ‫ءة‬1ddd5‫ر ﺏ‬1ddG/‫ أ‬1dd#‫ح دا‬dd.‫ی‬ 9d ‫ق‬dl 9* B8!‫ > ی‬1!1a 82‫ اا‬M‫آ‬1U‫ ا‬1#‫ دا‬ML‫ی‬
1L,ddddd+ 9dddd dddd n) ‫ءة‬1dddd5‫ﺏ‬ 9 dddH8‫ ﺕ‬1L,ddd+ 9ddd ddd n) 9 ddH8‫ ﺕ‬1L,dd+ 9dd dd n) Md8‫أو ﺕ‬/‫ءة و‬1;‫ آ‬9 H8‫ ﺕ‬1L,+ ddd] ‫( ﺏ‬ddd)* 1 !)ddd ‫ﺙ‬:ddd‫ ﺕ‬0ddd‫ا‬
‫أو‬/‫ و‬Mddd‫ءة ا‬1ddd;‫ آ‬9 dddH8‫ﺕ‬ M‫آ‬1ddddU Mdddd8‫أو ﺕ‬/‫ءة و‬1dddd;‫آ‬ M‫آ‬1dddU Mddd8‫أو ﺕ‬/‫ءة و‬1ddd;‫آ‬ ‫ح‬dd.‫درا ی‬1dd‫ و‬.Mdd‫ ا‬M‫آ‬1ddU ddd./  ]dddH‫ ا‬Mddd!.‫ ی‬.Mddd‫ا‬
Bd8!‫ وی‬.M‫ ا‬M‫آ‬1U M8‫ﺕ‬ 9dddd* Bdddd8!‫ ی‬$dddd‫ و‬.Mdddd‫ا‬ 1dd‫ دوری‬Bdd8!‫ ی‬$dd‫ و‬.Mdd‫ا‬ 0dddd‫ وا‬dddd n) ‫ءة‬1dddd5‫ر ﺏ‬1ddddG/‫ا‬ > .ddddd‫دی‬1‫ت ا‬1ddddd!‫ اا‬9ddddd*
9dH8‫ق ﺕ‬dl 9* ‫ار‬1‫ﺏ‬ ‫ ا@داء‬9 ddddddddddH8 ‫ق‬ddddddddddl ‫ ا@داء‬9 ddH8 ‫ق‬ddl 9dd* Mddd8‫أو ﺕ‬/‫ءة و‬1ddd;‫ آ‬9d d 9dddH8‫ﺕ‬ ‫ار او‬ddddd>‫ ا‬0ddddd/ ddddda‫ی‬
‫ة‬#‫ا‬$ddddd‫دي و ا‬ddddd;‫ا@داء ا‬ 0d‫ة وا‬#‫ا‬$d‫ا;دي وإداء ا‬ ‫ة‬#‫ا‬$dddddddd‫دي وأداء ا‬dddddddd;‫ا‬ (ddd‫ج ا‬1ddd8‫ ی‬. Mddd‫ ا‬M‫آ‬1dddU ‫وت‬$dddddd‫ ﺏ‬dddddL ‫ي‬1ddddd‫ء ﺏ‬$ddddd!‫ا‬
9dd ‫ت‬1dd‫ق ا‬dd;‫ ﺕ‬0dd‫وا‬ cRdddd‫ ه‬9dddd ‫ت‬1dddd‫ق ا‬ddd;‫ﺕ‬ 9d ‫ت‬1d‫ق ا‬d;‫ ﺕ‬0‫وا‬ ‫م‬1dddddddd .) )dddddddd7; ‫ت‬1dddddddd )‫ﺕ‬ 9ddddddddd )ddddddddd7; ‫ت‬1ddddddddd )‫ﺕ‬
‫رك‬1dddddU‫ وی‬،ddddd; ‫ ا‬cRddddd‫ه‬ ‫ف‬dd‫ ی‬1dd ‫ا‬d A‫ آ‬.dd; ‫ا‬ ‫ف‬ddddd‫ ی‬.ddddd; ‫ ا‬cRddddd‫ه‬ .‫ة‬$‫ی‬$Z‫ت ا‬1L1‫ﺏ‬ .‫ف‬U‫ا‬
‫ة‬#‫ا‬$dd‫ت ا‬1dd18‫ار ﺏ‬dd1‫ﺏ‬ ‫م‬d.‫ة وی‬#‫ا‬$d‫ت ا‬1d1% ()* ‫ت‬1ddddd1% (ddddd)* ‫م‬1ddddde1‫ﺏ‬ .51 ‫ار‬6 ‫ذ‬1"‫ب إﺕ‬4!‫ﻡ‬
0dd;‫ ﺕ‬0dd‫ل ا‬1dd*@1‫م ﺏ‬dd.‫وی‬ ‫ون‬$‫ ﺏ‬1L‫ ﺏ‬0;‫ ﺕ‬0‫ل ا‬1*@1‫ﺏ‬ ‫ل‬1ddd*@1‫م ﺏ‬ddd.‫ة وی‬#‫ا‬$ddd‫ا‬
. /‫ا‬+‫ت ا‬1 )‫ون ﺕ‬$‫ ﺏ‬1L‫ﺏ‬ . /‫ا‬+‫ت ا‬1 )‫ﺕ‬ ‫د‬dd‫ و‬$dd5* 1ddL‫ ﺏ‬0dd;‫ ﺕ‬0dd‫ا‬
9dddddd dddddd15 ‫ى‬ddddddH
. /‫ا‬+k‫ت ا‬1 )‫ا‬
Consistently generates Often suggests Regularly suggests Often does not seek Consistently ignores
constructive ideas for constructive ideas for constructive ideas for ways to improve obvious problems that
change that will change that will change that will individual and will negatively affect
improve work improve work improve work departmental the work environment.
effectiveness and/or effectiveness and/or effectiveness and/or performance. Seldom Only accepts
address work address work address work suggests constructive responsibility for
problems. Consistently problems. May seek problems. Periodically ideas for change that regular duties.
seeks ways to improve ways to improve may seek ways to will improve work Unwilling to start or
individual and individual and improve individual and effectiveness and/or continue any task
department department department address work without detailed
performance that go performance that go performance that go problems. Requires instructions from
beyond expectations beyond expectations beyond expectations explicit instructions to supervisor. Immediate
for this position. for this position. Often for this position. undertake a new task. action is required.
Consistently anticipates department Regularly anticipates
anticipates needs and takes departmental needs
departmental needs actions to meet them and takes action to
and takes action to with little supervisory meet them with an
meet them without direction. appropriate level of
supervisory direction. supervisory direction.

Please support your rating in the narrative section below: 01‫ن ا‬1G‫ ا‬0/ ^ .‫* ﺕ‬$‫ ی‬1 ‫ح‬+ (‫ی‬

4 Revised 6/09
 :. 4 12# ‫ ﻡى أه‬-5‫ ا‬A ‫ ﺏ‬CD  E#‫ت ا‬1>4!#‫ء ﺏ‬1D‫ ا‬-5
5. MEETING CHANGING DEMANDS OF THE WORK ENVIRONMENT
Importance to Position Critical 01‫ا‬ Very Important ‫ا‬$ ‫م‬1‫ه‬ Important ‫م‬1‫ه‬
،‫ة‬$‫ی‬$Z‫ ا‬1 5G‫د ا‬1*>‫ و‬،‫ة‬$‫ی‬$Z‫ام ا@اءات ا‬$‫ ا‬0/ !a‫ ا‬1L / 1‫ ﺏ‬M‫ ﺏ ] ا‬0/ ‫وف‬e‫ ات ا‬n‫ ﺕ‬05!‫ ﺕ‬0/ !a‫ ی\ ا‬1 /
. n1‫ ﺏ‬.)‫ت ا‬1l1U5‫ ا‬h !‫ ﺕ‬0/ ‫ة‬$*1H‫وا‬
Consider willingness to adapt to changing conditions in the work environment including willingness to utilize new procedures, to
adapt to new technology, and to assist in implementing change-related activities.

Q‫ى ﺏ‬R8‫ی‬/0‫ذ‬ ‫ء‬15A1‫ی ﺏ‬$ 02 9 H8‫ج ﺕ‬18‫ی‬ ‫!ل‬.  a

Exemplary Commendable Satisfactory Needs Improvement Unacceptable
 n‫ت ﺕ‬1!‫ار ﺕ‬1‫ ﺏ‬L;‫ی‬  n‫ت ﺕ‬1!‫ ﺕ‬1!1a L;‫
& ی‬G‫در *)( ا‬1 ‫دة‬1* ‫ن‬G‫ی‬  n‫
& ﺕ‬G‫ ا‬0/ ‫ ا‬A‫ آ‬MU;‫
& ی‬G‫ ا‬0/ ‫ار‬1‫ ﺏ‬MU;‫ی‬
()* ‫در‬1‫ و‬M‫ت ا‬1!) ()* ‫در‬1‫ و‬M‫ت ا‬1!) ()* ‫در‬1‫ و‬. M‫ت ا‬1!) ‫م‬$.‫ و> ی‬.M‫ت ا‬1!) ‫وم‬1.‫ و ی‬.M‫ت ا‬1!)  n‫ﺕ‬
cR‫ءة & ه‬1;G‫
ﺏ‬G‫ا‬ cR‫ءة & ه‬1;G‫
ﺏ‬G‫ا‬  n) ‫ت‬1%. ‫ی‬$.‫ﺕ‬ ‫وم‬1.‫ ی‬$‫  و‬n) ‫ت‬1%. .‫وری‬X‫ ات ا‬n‫ ا‬M*
‫ت‬1%. ‫م‬$.‫ ی‬،‫ ات‬n‫ا‬ ‫ة‬$  ‫ت‬1%. ‫م‬$.‫ ی‬،‫ ات‬n‫ا‬ & ‫ا‬$  M‫ وی‬،
G‫وا‬ .‫وری‬X‫ ات ا‬n‫ ا‬M* .9‫ﺥی‬p‫ون & ا‬1‫ ا‬q/‫وی‬
،
G‫  وا‬n) ‫ءة‬15‫ﺏ‬ & M‫ وی‬،
G‫  وا‬n) .‫ ات‬n‫ ا‬h ! 9‫ﺥی‬p‫ا‬ ‫ري‬D ‫ب إاء‬4!‫ﻡ‬
‫ار‬1‫ ﺏ‬9‫ﺥی‬p‫ ا‬$*1H‫وی‬ ‫ت‬1!)1‫ء ﺏ‬1/) 9‫ﺥی‬p‫ا‬
.‫ ات‬n‫ ا‬h !‫*)( ﺕ‬ .Z5 ‫ﺏق‬
Consistently Often understands the Regularly is able to Often fails to adapt to Consistently fails to
understands the implications of adapt to changing work changing work adapt to changing work
implications of changing work demands. Is able to demands. Does not demands. Resists
changing work demands. Provides make suggestions for make suggestions for making the necessary
demands and is able to good suggestions for change and to work change and may resist changes and refuses to
adapt effectively to change and adaptation well with others to making the necessary cooperate with others.
those changes. and works with others implement the changes. Immediate action is
Provides constructive to meet the new changes. required.
suggestions for change demands in productive
and adaptation. ways.
Consistently assists
others to adapt to the
changes.

Please support your rating in the narrative section below: 01‫ن ا‬1G‫ ا‬0/ ^ .‫* ﺕ‬$‫ ی‬1 ‫ح‬+ (‫ی‬

5 Revised 6/09
 :54 12# ‫ ﻡى أه‬: H"I‫ت ا‬16+‫ ا‬-6
6. INTERPERSONAL RELATIONSHIPS - Importance to Position Critical 01‫ا‬ Very Important ‫ا‬$ ‫م‬1‫ه‬ Important ‫م‬1‫ه‬

M+‫ أ‬1!15 ^‫ن ذ‬1‫ا آ‬Ra‫ و‬، 9#1‫ﺏ‬J‫آ وا‬U‫ ا‬0/ 9‫ﺥی‬p‫ص ا‬1+@‫ وا‬M‫ء ا‬W‫آ & ز‬U M* ‫ت‬1W* ‫ وإدا‬F ,‫ ﺏ‬h)‫ ی‬1 /
.;)‫ت ا‬1/1.A‫س ذوي ا‬15‫ ا‬9 ‫ت ﺏ‬1/W‫>ﺥ‬1‫ ﺏ‬/‫و ا‬/‫  ـ‬1H8‫ر ا‬1!*>‫ ا‬9 ‫ ﺏ‬R‫ ﺥ‬.‫م‬1‫ر ا‬LZ‫ر  وا‬1‫ت ا‬1LZ‫ا‬
Consider willingness to establish and maintain cooperative working relationships with co-workers and other members of the
Company; if appropriate include external agencies and the general public. Consider sensitivity to and awareness of differences
in people of diverse backgrounds.

Q‫ى ﺏ‬R8‫ی‬/0‫ذ‬ ‫ء‬15A1‫ی ﺏ‬$ 02 9 H8‫ج ﺕ‬18‫ی‬ ‫!ل‬.  a

Exemplary Commendable Satisfactory Needs Improvement Unacceptable
‫ة‬$  ‫ت‬1W* ()* 1#‫ دا‬u/18‫ة ی‬$  ‫ت‬1W* ()* 1!1a u/18‫ی‬ ‫ت‬1W* ()* ‫دة‬1* u/18‫ی‬ & Q‫ﺕ‬1W* 0/ M‫آ‬1U Q‫ی‬$ ‫دة‬1* 0/ M‫آ‬1U ‫ار‬1‫ ﺏ‬Q‫ی‬$
9 ‫ى‬H /‫ وی‬،9‫ﺥی‬p‫ & ا‬9 ‫ى‬H /‫ وی‬،9‫ﺥی‬p‫& ا‬ /‫ وی‬،9‫ﺥی‬p‫ة & ا‬$  ‫ر‬1L‫ إ‬0/ MU;‫ وی‬،9‫ﺥی‬p‫ا‬ Q7.5‫ ی‬،9‫ﺥی‬p‫ & ا‬Q‫ﺕ‬1W*
1‫ی ﺏ‬.‫ وا‬J‫ وای‬،‫ة‬$*1H‫ ا‬1‫ی ﺏ‬.‫ وا‬J‫ وای‬،‫ة‬$*1H‫ا‬ ،‫ة‬$*1H‫ ا‬9 ‫ى‬H ‫ت‬11% c1Z‫  ﺕ‬1H8‫ا‬ /15‫ ﺕ‬0/ ‫ وه‬،9‫ﺥی‬p‫ام ا‬%‫ا‬
9 ‫ ا)ب‬9* ‫ ا‬A‫ آ‬$‫ی‬J‫ی‬ 9 ‫ ا)ب‬9* ‫ ا‬A‫ آ‬$‫ی‬J‫ی‬ !15‫ی ا‬.‫ وا‬J‫وای‬ 0/  )*1;‫ ﺏ‬$*1H‫ و> ی‬،9‫ﺥی‬p‫ا‬ ،9‫ﺥی‬p‫ت ا‬11% &
M‫ ا‬0/ Q‫ﺕ‬1W* .; ‫ا‬ M‫ ا‬0/ Q‫ﺕ‬1W* .; ‫ا‬ .; ) .9‫ﺥی‬p‫ی ود* ا‬.‫ﺕ‬ .‫ري‬D ‫ب إاء‬4!‫ﻡ‬
 ‫ﺏ‬1Z‫ء ﺏ ] ای‬15‫ ﺏ‬0/ L1H‫ﺕ‬ . ‫ﺏ‬1Z‫ء ﺏ ] ای‬15‫ ﺏ‬0/ L1H‫ﺕ‬
.‫ی‬
Consistently maintains Often maintains very Regularly maintains Often has problems Consistently has
exceptional good relationships with good relationships with relating to others and problems relating to
relationships with others, providing a others, providing a fails to demonstrate others, lacks respect
others, providing a very level of assistance, level of assistance, sensitivity to others’ for others, and is
high level of reinforcement, and reinforcement, and needs; does not indifferent to others’
assistance, support that goes support appropriate for actively assist, needs. Immediate
reinforcement, and beyond that required the position. reinforce, or support action is required.
support that goes by the position. Work others.
beyond that required relationships contribute
by the position. Work to a positive
relationships con- environment.
tribute to a strong
positive environment.

Please support your rating in the narrative section below: 01‫ن ا‬1G‫ ا‬0/ ^ .‫* ﺕ‬$‫ ی‬1 ‫ح‬+ (‫ی‬

6 Revised 6/09
 :. 4 12# ‫ أه‬:5‫آ‬1I‫ ا‬5‫ ﺡ‬-7
7. PROBLEM SOLVING- Importance to Position Critical 01‫ا‬ Very Important ‫ا‬$ ‫م‬1‫ه‬ Important ‫م‬1‫ه‬
.15‫ ا‬j1‫ وﺏ‬1 )* 1L. !‫ وﺕ‬،!15 )‫ی‬$‫)ل ﺏ‬% (‫ ود اﺹل ا‬،W.H M‫آ‬1U‫ \ ا‬U‫ اف *)( وﺕ‬0/ !a‫ا‬
Consider willingness to recognize and independently diagnose problems, accurately develop appropriate alternatives, and
implement practical and effective solutions in a timely manner.

Q‫ى ﺏ‬R8‫ی‬/0‫ذ‬ ‫ء‬15A1‫ی ﺏ‬$ 02 9 H8‫ج ﺕ‬18‫ی‬ ‫!ل‬.  a

Exemplary Commendable Satisfactory Needs Improvement Unacceptable
‫ت‬11% 0/ ‫رك‬1U‫ار ی‬1‫ﺏ‬ ‫ن‬1G ‫ت‬11% ‫رك‬$‫ ی‬1!1a ‫ اف‬0/  U ‫دة ه‬1* M‫آ‬1U‫رك ا‬$‫ > ی‬1!1a ‫ إدراك‬0/ ‫ار‬1‫ ﺏ‬MU;‫ی‬
1L‫ء ﺏ‬1/) M‫ وی‬M‫ن ا‬1G 1L‫ء ﺏ‬1/) M‫ وی‬M‫ا‬ M‫ن ا‬1G ‫ت‬11% ()* 0/‫ و‬M‫ ا‬0/  5 ‫اوﺕ‬ 0/  5 ‫ اوﺕ‬M‫آ‬1U‫ا‬
0/ $‫ ا‬9 0#15A‫ى ا‬H‫ﺏ‬ 0/ $‫ ا‬9 ‫ل‬1* ‫ى‬H‫ﺏ‬ j‫ ا‬0/ 1/ >)% ‫ویر‬ ‫ن‬1 %@‫ ا‬q‫ﺏ‬ ‫ن‬1 %@‫ ا‬q‫ ﺏ‬0/‫ و‬M‫ا‬
M%‫ \ و‬U‫ا@دراك وا‬ M%‫ \ و‬U‫ا@دراك وا‬ \U‫رك وی‬$‫ ی‬،15‫ا‬ M% M:‫ی‬/Ml1‫ی‬ M% M:‫ی‬/Ml1‫ی‬
M‫آ‬1U‫ ا‬1L / 1‫ ﺏ‬M‫آ‬1U‫ا‬  a M‫آ‬1U‫ ا‬1L / 1‫ ﺏ‬M‫آ‬1U‫ا‬ ‫رج‬1‫;دا وﺥ‬5 M‫آ‬1U‫ ا‬M8‫وی‬ Q5* i5‫ ی‬1 ،M‫آ‬1U‫ا‬ Q5* i5‫ ی‬1 ،M‫آ‬1U‫ا‬
j‫ ا‬0/‫ و‬،‫ا‬$ .‫ ﺕ‬A‫ا@آ‬ j‫ ا‬0/‫ و‬، 5 ‫اوﺕ‬ .; ‫ق ا‬1 9* . 1>‫
ا‬2 ‫ا‬R‫  وه‬1>‫
ا‬2
.15‫ا‬ .15‫ا‬ ‫ *)( أداء‬1 !) :‫ﺙ‬:‫ی‬
.; ‫ا‬
‫ذ إاء‬1"‫ب اﺕ‬4!‫ﻡ‬
.‫ري‬D
Consistently Often anticipates Regularly is effective Often does not Consistently fails to
anticipates workplace workplace needs and in anticipating recognize or recognize or
needs and works to works to meet them workplace needs and misdiagnoses routine misdiagnoses routine
meet them with an with a high level of developing effective problems. problems.
exceptional level of accuracy in solutions in a timely Sometimes Procrastinates in
accuracy in recognizing, manner. Re- procrastinates in addressing problems
recognizing, diagnosing, and cognizes, diagnoses, addressing problems, resulting in poor
diagnosing, and resolving problems, and resolves resulting in poor outcomes that
resolving problems, including non-routine problems outcomes. negatively impact job
including the most problems, in a timely independently within performance.
complex, in a timely manner. the scope of the Immediate action is
manner. position. required.

Please support your rating in the narrative section below: 01‫ن ا‬1G‫ ا‬0/ ^ .‫* ﺕ‬$‫ ی‬1 ‫ح‬+ (‫ی‬

7 Revised 6/09
 :. 4 12# ‫ اه‬:‫ی‬.I‫ت ا‬1H‫ اﺕ‬-8
8. VERBAL COMMUNICATION SKILLS- Importance to Position Critical 01‫ا‬ Very Important ‫ا‬$ ‫م‬1‫ه‬ Important ‫م‬1‫ه‬
.‫س‬15‫ & ا‬M‫ ااﺹ‬$5* L;‫ ا‬9 $‫آ‬,‫ار وا‬1‫ع ﺏ‬1>‫ وا‬. ‫ ود‬82‫;ی وا‬+ ‫>ت‬17‫ﺕ‬1‫م ﺏ‬1 .‫رة *)( ا‬$.1‫ ﺏ‬h)‫ﺕ‬
Consider the ability to provide clear, concise, and effective verbal communication, and consistently listen and check for
understanding when communicating with all people.

Q‫ى ﺏ‬R8‫ی‬/0‫ذ‬ ‫ء‬15A1‫ی ﺏ‬$ 02 9 H8‫ج ﺕ‬18‫ی‬ ‫!ل‬.  a

Exemplary Commendable Satisfactory Needs Improvement Unacceptable
‫ت‬1) ‫ار‬1‫ ﺏ‬/‫ی‬ 82‫ت وا‬1) /‫ ی‬1!1a ‫ت‬1) /‫دة ی‬1* )1‫  آ‬a ‫ت‬1) /‫ ی‬1!1a  a ‫ت‬1) ‫ار‬1‫ ﺏ‬/‫ی‬
. ‫ ود‬8 8‫ وﺹ‬82‫وا‬ &H‫ ی‬. ‫ ود‬8 8‫وﺹ‬ . ‫ ود‬8 8‫ وﺹ‬82‫وا‬ 1!1a ،+U‫ و‬8 8‫  ﺹ‬a‫ و‬،+U‫ و‬8 8‫  ﺹ‬a‫) و‬1‫آ‬
9‫ﺥی‬w  )*1;‫& ﺏ‬H‫ی‬ $‫آ‬,‫ ی‬1!1a‫ و‬9‫ﺥی‬w  )*1;‫ﺏ‬ ‫ ویف‬9‫ﺥی‬w &H‫ی‬ 9‫ﺥی‬w ‫ع‬1>‫ ا‬0/ MU;‫ی‬ ‫ع‬1>‫ ا‬0/ MU;‫ ی‬1!1a
LL;‫ ﺕ‬9 $‫آ‬,‫ار ی‬1‫وﺏ‬ ‫ع ااد‬2) LL;‫ ﺕ‬9 ‫ع‬2) LL;‫*)( ﺕ‬ LL;‫ اف *)( ﺕ‬0/‫و‬ ()* ‫ اف‬0/‫ و‬9‫ﺥی‬w
.L Q) ‫ع ااد ﺕﺹ‬2) .L Q) ‫ﺕﺹ‬ .L Q) ‫ااد ﺕﺹ‬ .L Q) ‫ع ااد ﺕﺹ‬2) ‫ع ااد‬2) LL;‫ﺕ‬
.L Q) ‫ﺕﺹ‬
.51 ‫ذ إاء‬1"‫ب اﺕ‬4!‫ﻡ‬
Consistently provides Often provides Regularly provides Often conveys Consistently provides
information that is information that is very information that is information that is information that is
exceptionally clear, clear, correct, and clear, correct, and incomplete, incorrect, incomplete, incorrect,
concise, and complete; concise; listens to concise; listens to or confusing; often fails or confusing;
listens to others others effectively and others and often to listen to others and consistently fails to
effectively and often verifies their verifies their to verify their listen to others and to
consistently verifies understanding of what understanding of what understanding of what verify their
their understanding of is being is being is being understanding of what
what is being communicated. communicated. communicated. is being
communicated. communicated.
Immediate action is
required.

Please support your rating in the narrative section below: 01‫ن ا‬1G‫ ا‬0/ ^ .‫* ﺕ‬$‫ ی‬1 ‫ح‬+ (‫ی‬

8 Revised 6/09
 SECTION II C1J‫ ا‬KLM‫ا‬
OPTIONAL CRITERIA ‫ری‬1 #‫ اﺥ‬O1H‫ﺥ‬
< M#‫م ﺏ‬M‫ اي ﺕ‬1‫ ﺏ‬M4#‫ ا‬C‫ ا;اﺡ‬MD 5‫اآ‬
(Complete only those criteria that are pertinent to the employee you are appraising.)
:. 4 12# ‫ أه‬:‫ﺏ‬1#Q‫رات ا‬12‫ ﻡ‬-9
9. WRITING SKILLS - Importance to Position Critical 01‫أ‬ Very Important ‫ا‬$ ‫م‬1‫ه‬ Important ‫م‬1‫ه‬
1. ‫ ود‬182‫ وا‬،1e5 ‫ب‬G‫ ا‬M‫ ا‬1L / ‫ن‬G‫ ی‬0‫ر ا‬$‫   ا( ا‬. &H) 15‫ى ا‬H‫ ا‬0/ ‫ﺏ‬1‫ت آ‬1)‫ ا‬9*  !‫رة ا‬$ !*‫إ‬
.‫ا‬7‫و‬
Consider ability to express information in writing at a level that is appropriate to the audience. Assess the degree to which
written work is organized, clear, accurate, and concise.

Q‫ى ﺏ‬R8‫ی‬/0‫ذ‬ ‫ء‬15A1‫ی ﺏ‬$ 02 9 H8‫ج ﺕ‬18‫ی‬ ‫!ل‬.  a

Exemplary Commendable Satisfactory Needs Improvement Unacceptable
. ‫ ود‬،e5 1#‫ دا‬Q‫ﺕ‬1‫ﺏ‬1‫آ‬  .5‫ و‬82‫دة وا‬1* Q‫ﺕ‬1‫ﺏ‬1‫آ‬ ‫ات‬$5H ‫م‬1e1‫ ﺏ‬/‫ی‬ !.  a 1!1a Q‫ﺕ‬1‫ﺏ‬1‫آ‬ 01 $‫ی‬$8‫ ﺕ‬7‫ ا‬9
،1L5 ‫ض‬n1‫ ﺏ‬0;‫) وﺕ‬G‫و‬ ‫ي‬8‫ وﺕ‬،. ‫) ود‬G‫و‬ ،. ‫ ود‬82‫ﺏ وا‬G 0/ ‫م‬1* 9 H8‫ج ا( ﺕ‬18‫م وﺕ‬$* ‫ أو‬،‫ء‬1‫! ا@ﺥ‬H‫ ﺏ‬Q‫ﺕ‬1‫ﺏ‬1‫آ‬
‫د‬1*>  #15A‫رات ا‬$ Q‫ی‬$ Q‫راﺕ‬1L ،!15‫ ا‬M ‫ﺹ‬1;‫ا‬ ‫ ﺕ;ق‬$‫ و‬0;‫رات ﺕ‬1L‫ا‬  !‫ ا‬0/ MU;‫ ی‬1!1a .‫دة‬Z‫ا‬ ‫ أو‬، e5‫م ا‬$* ‫ل أو‬1‫ا>آ‬
(‫ﺏ )ﺹل ا‬1‫ا)ب آ‬ cR‫ت ه‬1!) ‫ وﺕ;ق‬$. ‫ی  ا)ﺏ‬1‫ ا‬11 %‫أ‬ ،‫ة‬$  .‫ت ﺏی‬1)‫ ا‬9*  n‫ت ا‬1‫ی‬8‫أو ا‬/‫ر و‬1G/@‫ا‬
1 / ،05‫ري ا‬1.‫اف وا‬$‫ا@ه‬ .; ‫ا‬ .; ‫ ا‬cRL  a ‫ن‬1 %@‫ ا‬q‫ ﺏ‬0/ Q)*‫  ذات و‬a ‫ت‬1)‫ أو ا‬8 8‫ﺹ‬
‫ة أو‬$.‫ت ا‬1 )1‫ ﺏ‬h)‫ی‬ .MG  a ‫أو‬/‫ و‬m2‫وا‬ .W‫ا‬
.‫ح‬2‫ت ﺏ‬1)‫ا‬ . >‫ آ‬R L‫ج ا' ﺕ‬1#‫ی‬
Writing consistently is Writing often is clear, Regularly provides Writing often is Difficult to determine
organized, precise, logical, complete, and clear, concise, and unacceptable and the meaning of written
complete, and meets precise, including effective written needs improvement in communication
its stated objectives. appropriate details. documents. Skills overall quality. Often because of errors,
Exceptional ability to Skills are advanced meet, and occasionally fails to express incomplete or
adapt writing style to and exceed the may exceed, those information well; work disorganized
the objectives and requirement of this required of this sometimes is unclear presentation of ideas,
intended readers and position. position. and/or incomplete. and/or inclusion of
to relate complex incorrect or irrelevant
instructions or information. Major
information clearly. improvements are
required.

Please support your rating in the narrative section below: 01‫ن ا‬1G‫ ا‬0/ ^ .‫* ﺕ‬$‫ ی‬1 ‫ح‬+ (‫ی‬

9 Revised 6/09
 :. 4 12# ‫ أه‬: K‫ی‬M#‫رات ا‬12‫ ﻡ‬-10
10. PRESENTATION SKILLS - Importance to Position Critical 01‫ا‬ Very Important ‫ا‬$ ‫م‬1‫ه‬ Important ‫م‬1‫ه‬
‫ل‬1/ ‫ی‬$.‫ی ﺕ‬$.‫ ﺕ‬M*‫;ي و‬U‫ل ا‬17‫رة *)( ا>ﺕ‬$.‫ر ا‬$
Consider the ability to communicate verbally and to make effective oral presentations.
Q‫ى ﺏ‬R8‫ی‬/0‫ذ‬ ‫ء‬15A1‫ی ﺏ‬$ 02 9 H8‫ج ﺕ‬18‫ی‬ ‫!ل‬.  a
Exemplary Commendable Satisfactory Needs Improvement Unacceptable
M* 0/ ‫ار ;ق‬1‫ﺏ‬ M  ‫ی‬1‫ ی;ق ا‬1!1a ‫ ی;ق‬11 %‫ وأ‬0;‫ ی‬1#‫دا‬ (‫ﺹل ا‬1‫ ﺏ‬MU;‫ ی‬،1!1a ‫ اﺹل‬0/ ‫ار‬1‫ ﺏ‬MU;‫ی‬
،1/ ‫;ی‬+ ‫>ت‬17‫اﺕ‬ ،1/ ‫;ی‬+ ‫>ت‬17‫اﺕ‬ ‫>ت‬17‫ اﺕ‬M  ‫ی‬1‫ا‬ ‫;ی‬+ ‫>ت‬17‫ اﺕ‬M  ‫ی‬1‫ا‬ ‫>ت‬17‫ اﺕ‬M  ‫ی‬1‫ا( ا‬
 #15A‫رات ا‬$ Q‫ی‬$‫و‬ ‫ا‬$ ‫ة‬$  ‫رات‬$ Q‫ی‬$‫و‬ ‫رات‬$ Q‫ی‬$‫ و‬،1/ ‫;ی‬+ M ‫ ﺕﺹ‬0/ MU;‫ ی‬1!1a‫ و‬،1/ ‫ار‬1‫ ﺏ‬MU;‫ وی‬،1/ ‫;ی‬+
L‫ط ا‬1.5‫ ا‬M ‫ﺹ‬ L‫ط ا‬1.5‫ ا‬M ‫ﺹ‬ L‫ط ا‬1.5‫ ا‬M ‫ﺹ‬ .‫ح ﺏی‬2‫ ﺏ‬L‫ط ا‬1.5‫ا‬ L‫ط ا‬1.5‫ ا‬M ‫ ﺕﺹ‬0/
!15 .‫ح ﺏی‬2‫ﺏ‬ !15 .‫ح ﺏی‬2‫ﺏ‬ !15 .‫ح ﺏی‬2‫ﺏ‬ .&H) !15 !15 .‫ح ﺏی‬2‫ﺏ‬
.&H) .&H) .&H) .&H)
.51 ‫ب إاء‬4!‫ﻡ‬
Consistently excels at Often exceeds the Regularly meets, and Often fails to meet the Consistently fails to
making effective oral standards for making may occasionally standards for making meet the standards for
presentations; has effective oral exceed, the standards effective oral making effective oral
exceptional ability to presentations; has for making effective presentations; often presentations;
convey important very good ability to oral presentations; fails to convey consistently fails to
points clearly in a way convey important has the ability to important points convey important
that is appropriate to points clearly in a way convey important clearly or may not points clearly or fails
the audience. that is appropriate to points clearly in a way present them in a way to present the points
the audience. that is appropriate to that is appropriate to in a way that is
the audience. the audience. appropriate to the
audience. Immediate
action is required.

Please support your rating in the narrative section below: 01‫ن ا‬1G‫ ا‬0/ ^ .‫* ﺕ‬$‫ ی‬1 ‫ح‬+ (‫ی‬

10 Revised 6/09
 :. 4 12# ‫ أه‬:R1‫ﺏ‬91‫ل ﺏ‬1H‫ﺕ‬S‫رات ا‬12‫ ﻡ‬-11
11. CUSTOMER CONTACT SKILLS - Importance to Position Critical Very Important Important
M‫ & آ‬Q)1‫ل ﺕ‬W‫ ﺥ‬M.‫ت وا‬1‫ر‬1‫ وا‬9H;5‫! ا‬2‫ص و‬8‫  وا‬1H‫ام ا‬$1‫دة ﺏ‬Z‫  ا‬1* $‫ ﺥ‬$‫وی‬J‫ ﺕ‬0/ !a1‫ ﺏ‬h)‫ ی‬1 /
1L )* M78‫ ی‬0‫ی اا ا‬Rn‫*  ا‬5‫ اه ﺏ‬1X‫ أی‬.9‫ واردی‬9‫س ا@ﺥی‬15‫ وا‬9#1‫ﺏ‬J‫ وا‬M‫ب ا‬18‫ واﺹ‬،‫ء‬WJ‫ وا‬9 )1‫)ا‬9#1‫ﺏ‬J‫ا‬
.9#1‫ﺏ‬J‫ ا‬9
‫ا‬
Consider willingness to provide consistent high-quality service using tact, courtesy, self-control, patience, and discretion during
interactions with all customers (students, faculty, staff, the public, and/or outside agencies). Also consider the type of feedback
that this employee receives from customers.

Q‫ى ﺏ‬R8‫ی‬/0‫ذ‬ ‫ء‬15A1‫ی ﺏ‬$ 02 9 H8‫ج ﺕ‬18‫ی‬ ‫!ل‬.  a

Exemplary Commendable Satisfactory Needs Improvement Unacceptable
‫ت‬1$‫ ا‬M‫ ی‬1#‫دا‬ ‫ت‬1$‫ ا‬M‫ ی‬1!1a ‫ت‬1$‫ ا‬M‫دة ی‬1* ‫ى‬H‫ت ﺏ‬1$‫ ا‬M‫دة ی‬1*
2 ‫ى‬H‫را ﺏ‬11‫دي ﺏ‬:‫ی‬
9#1‫ﺏ‬J) 0#15A‫ى ا‬H‫ﺏ‬ 02 ‫ل‬1* ‫ى‬H‫ﺏ‬ 9#1‫ﺏ‬J) 02 ‫ى‬H‫ﺏ‬ 9 )‫اﺥ‬$‫ ا‬9#1‫ﺏ‬J) 02  a 9 )‫اﺥ‬$‫ ا‬9#1‫ﺏ‬J) $‫ ا‬9
،9 ‫ر‬1‫ وا‬9 )‫اﺥ‬$‫ا‬ 9 )‫اﺥ‬$‫ ا‬9#1‫ﺏ‬J) ،9 ‫ر‬1‫ وا‬9 )‫اﺥ‬$‫ا‬ M* 0/ MU;‫ وی‬،9 ‫ر‬1‫وا‬ M* 0/ MU;‫ وی‬،9 ‫ر‬1‫وا‬
‫ ه‬1 A‫ أآ‬M‫ ی‬1#‫ودا‬ 1 1!1a‫ و‬،9 ‫ر‬1‫وا‬ 9 ‫ ه )ب‬1 M‫ی‬ ; ‫ ا‬9 ‫ ه )ب‬1 ‫ء‬1/) ; ‫ ا‬9 ‫ا)ب‬
‫ء‬1/) ; ‫ ا‬9 ‫)ب‬ 9 ‫ ه )ب‬1 ‫ی;ق‬ ‫ت‬1!)‫ء ﺏ‬1/) ; ‫ا‬ .9#1‫ﺏ‬J‫ت ا‬1!)‫ء ﺏ‬1/) ()* M78‫ ی‬.9#1‫ﺏ‬J‫ت ا‬1!)‫ﺏ‬
.9#1‫ﺏ‬J‫ت ا‬1!)‫ﺏ‬ ‫ت‬11%  !) ; J‫ا‬ .9#1‫ﺏ‬J‫ا‬ ‫ی را‬Rn‫ *)( ﺕ‬M78‫وی‬ .9#1‫ﺏ‬J‫ ا‬9  !) ‫ی را‬Rn‫ﺕ‬
.9#1‫ﺏ‬J‫ا‬ .9#1‫ﺏ‬J‫ ا‬9  !) .‫ري‬D ‫ذ إاء‬1"‫ب اﺕ‬4!‫ﻡ‬
Consistently Often demonstrates Regularly Often demonstrates Consistently
demonstrates very high level of demonstrates unsatisfactory level of demonstrates poor
exceptional level of service to internal and satisfactory level of service to internal and level of service to
service to internal and external customers, service to internal and external customers, internal and external
external customers, often going beyond external customers, failing to do what is customers, failing to do
going substantially what is required of the doing what is required required of the position what is required of the
beyond what is position to meet of the position to meet to meet customers’ position to meet
required of the position customers’ needs. customers' needs. needs. Receives customers’ needs.
to meet customers’ negative feedback Consistently receives
needs. from customers. negative feedback
from customers.
Immediate action is
required.

Please support your rating in the narrative section below: 01‫ن ا‬1G‫ ا‬0/ ^ .‫* ﺕ‬$‫ ی‬1 ‫ح‬+ (‫ی‬

:‫اﺵاف‬/‫دة‬1 M‫ت ا‬1 AL‫ ﻡ‬-12

12. SUPERVISORY/LEAD RESPONSIBILITIES-
Importance to Position Critical 01‫أ‬ Very Important ‫ا‬$ ‫م‬1‫ه‬ Important ‫م‬1‫ه‬
‫ی‬Rn‫ وﺕ‬8+‫ت وا‬1‫ ﺕ‬/‫ وی‬.1L‫ﺕ‬1‫ی‬1a‫ة و‬$%‫اف ا‬$‫ه‬,‫ء ﺏ‬1/) M‫ت ا‬1‫ی‬Z ‫ﺏ‬1‫ و‬q‫  وا;ی‬e5‫ وا‬، ‫رة *)( ا‬$.1‫ ﺏ‬h)‫ﺕ‬
.‫ا‬$‫ ﺏ‬Q‫ی‬$‫ی‬: M1‫ ی‬1#‫ ودا‬.#‫ دا‬F‫ *)( ا‬q‫ءة )ی‬15‫ﺏ‬
Consider ability to plan, organize, delegate, and follow up on work-flow to meet unit’s goals and objectives. Provides clear
expectations and constructive feedback to subordinates on a consistent basis. Consistently treats subordinates fairly.

Q‫ى ﺏ‬R8‫ی‬/0‫ذ‬ ‫ء‬15A1‫ی ﺏ‬$ 02 9 H8‫ج ﺕ‬18‫ی‬ ‫!ل‬.  a

Exemplary Commendable Satisfactory Needs Improvement Unacceptable
9 ‫ت‬1‫ ی;ق ا‬1#‫دا‬ 9 ‫ت‬1‫ ی;ق ا‬1!1a 9 ‫ت‬11‫ ﺏ‬0;‫دة ی‬1* (‫ اﺹل ا‬9* JZ‫ ی‬1!1a (‫ اﺹل ا‬9* JZ‫ ی‬1#‫دا‬

‫ا‬/ ‫ف‬U‫ا‬ .‫]ل‬H‫ا
ا‬/ ‫ف‬U‫ا‬ .‫]ل‬H‫ا
ا‬/ ‫ف‬U‫ا‬ ‫ف‬U‫ ا‬9 ‫ت‬1‫ا‬ ‫ف‬U‫ ا‬9 ‫ت‬1‫ا‬
.‫]ل‬H‫ا‬ .‫]ل‬H‫ا
ا‬/ .‫]ل‬H‫ا
ا‬/
Consistently exceeds Often exceeds Regularly meets Often fails to meet Consistently fails to
expectations for expectations for expectations for expectations for meet expectations for
supervisory/lead supervisory/lead supervisory/lead supervisory/lead supervisory/lead
employee. employee. employee. employee. employee. Immediate
action is required.

Please support your rating in the narrative section below: 01‫ن ا‬1G‫ ا‬0/ ^ .‫* ﺕ‬$‫ ی‬1 ‫ح‬+ (‫ی‬

11 Revised 6/09
 SECTION III W1J‫ ا‬KLM‫ا‬
 D1‫ ;  أو إ‬L‫ی  ﺕ‬1‫ﻡ‬
X1‫ر أد‬1 ‫ ﻡ‬5‫ وی' وﺹ آ‬،1‫  ; ا‬D1‫ی  إ‬1‫أ ﻡ‬
ADDITIONAL OR ENHANCING CRITERION
01‫ ا;اغ ا‬0/ ‫اء‬$‫ی  ا‬1 M‫ ی( وﺹ
آ‬،jZ%‫ا ا‬Ra  /12‫\ إ‬#17‫
ﺥ‬2‫ا‬
(Add additional criteria if needed. Please describe each additional performance criterion below.)

13.
Importance to Position Critical 01‫ا‬ Very Important ‫ا‬$ ‫م‬1‫ه‬ Important ‫م‬1‫ه‬

Q‫ى ﺏ‬R8‫ی‬/0‫ذ‬ ‫ء‬15A1‫ی ﺏ‬$ 02 9 H8‫ج ﺕ‬18‫ی‬ ‫!ل‬.  a

Exemplary Commendable Satisfactory Needs Improvement Unacceptable

Please support your rating in the narrative section below: 01‫ن ا‬1G‫ ا‬0/ ^ .‫* ﺕ‬$‫ ی‬1 ‫ح‬+ (‫ی‬

SECTION IV Z‫ ااﺏ‬KLM‫ا‬

(If applicable, please complete sections A through C below.)

 ; ‫زات ا‬1Z@‫ ا‬9* )A‫اذآ أ‬

A. Provide examples of positive achievements.

9 H8)
‫ ا‬1% 9 !‫ة اا وﺕ‬/ ‫ل‬W‫ ﺥ‬j‫ﺙ‬$% ‫دة‬$8 )A‫اذآ أ‬
B. Provide specific examples that occurred during this review period which demonstrate this employee’s need for
improvement.

.
‫ا ا‬R‫ اداء ه‬9 H8‫  ﺕی وﺕ‬Q‫ ﺏ‬0‫ي ﺕﺹ‬R‫د ا‬$8‫ری أو ا)  ا‬$‫ ه ا‬1
C. What specific training or other learning experiences would you recommend for this employee’s performance
and development plan?

12 Revised 6/09
 OVERALL RATING ‫م‬1‫ ا‬K M#‫ا‬

Q‫ى ﺏ‬R8‫ی‬/0‫ذ‬ ‫ء‬15A1‫ی ﺏ‬$ 02 9 H8‫ج ﺕ‬18‫ی‬ ‫!ل‬.  a

Exemplary Commendable Satisfactory Needs Improvement Unacceptable
./ (‫ی ی‬$.‫ا ا‬R‫ه‬
‫ی‬1‫ ﺏ‬0;‫ ا
ی‬M*
a ‫ار‬1‫اداؤ ا
ﺏ‬
‫ت ا@داء‬1‫@*)( در‬
%@‫ ا‬q‫ ﺏ‬0/
‫ ا‬0;‫ی‬
a‫ و‬:;‫آ‬
‫ار‬1‫ي ی;ق ﺏ‬R‫وا‬
 وا‬11‫ﺏ‬ 
‫ی‬1‫ ا‬cR‫ ی;ق ه‬$ ‫ات‬/
A‫ آ‬0/ 9G‫ و‬، 
‫ی‬11‫ﺏ‬ .;
‫ت ا‬1 ()* ‫ﺥ
ة‬
‫ل‬W‫ت ﺥ‬1‫ی
 وا‬1‫ا‬ ‫درات‬1!‫ ا‬Le‫ وی‬،1L;‫ی‬
%@‫ا‬ R‫ري ﻡ‬D 5
‫ب‬4!‫ﻡ‬
‫ي‬R‫ ا
ا‬.
.‫ة ا‬/ .
/12‫زات إ‬1Z‫ﺏا ا‬
!) ‫ﺙ‬:‫ی‬ .X‫ أداء‬R L# ‫ا‬

.‫ا ا‬R‫ *)( ه‬M78‫ی‬
‫ﺏ‬1Z‫ت ی وای‬1‫رآ‬1U
MZ Q ‫ن‬G‫ أن ی‬Z‫ی‬
.‫زات‬1Z@‫ ا‬9 M‫اﺹ‬
.‫ ا‬0/ 02 ‫ى‬H
This rating is reserved
for the highest level of
performance that
consistently exceeds
standards and
expectations during the
evaluation period. An
employee receiving
this rating should have
a consistent record of
achievement.
()* h!5‫ی ی‬$.‫ا ا‬R‫ه‬ 
1$5* 1!15 ‫ن‬G‫ی ی‬$.‫ا ا‬R‫ه‬ 
0;‫ ی‬1#‫ي دا‬R‫ا
ا‬ 0/‫ و‬،‫ت ا@داء‬1‫ة وﺕ‬#‫ا‬$‫ا‬
‫ر‬$‫ﺙ ﺏ‬:‫!ل وی‬. 
1 1!1a‫ و‬9‫ﺕ‬1‫ی
9 
FG‫ی ی‬$.‫ا ا‬R‫ ه‬. ‫ت‬1‫وا‬
M‫م ﺏ‬.‫أن ا
ی‬ ‫ى ا@داء‬H ()* 1
0/ 
9H8‫ و*)( ا
أن ی‬،‫م‬1‫ا‬

) ‫م‬1‫ة وأن اأداء ا‬#‫ا‬$‫ا‬
.02
This rating applies to The employee’s work
an employee who regularly meets the
consistently meets department’s
standards and standards and
expectations, often expectations for
exceeds them, and performance;
shows initiative in periodically
additional performance may
achievements. exceed these
standards. This rating
reflects that the
employee makes a
solid and positive
contribution to the
department and that
the employee’s
performance is overall
satisfactory.
‫ن‬1
‫ي‬R‫^ وا‬R‫ ﺏ‬0;‫ن > ی‬1
c‫ وأداء‬Q/‫ و‬c‫د‬L 9H8‫ﺕ‬/
(‫ )ﺹل ا‬Q‫ و)آ‬Q‫راﺕ‬1L‫و‬
.
This rating is The employee’s
appropriate when an performance is
employee periodically consistently deficient,
meets the standards unacceptable, and
but too often does not seriously impacts job
do so, which negatively outcomes. Immediate
impacts the overall action by the
performance level. employee to improve
The employee must performance is
improve his/her efforts, required.
knowledge,
performance, skills,
and/or behavior in
order to achieve a
satisfactory level of
evaluation.

EMPLOYEE COMMENTS: (to be completed by employee only). (
‫ ا‬M! 9 MG‫) ﺕ‬ :‫ت ا‬1)‫ ﺡ‬+‫ﻡ‬

Employee Signature and Date (Signature does not indicate agreement)

(Q / ‫ء‬1 1 ()* ./‫ ا‬F  & ‫ )ا‬،V‫ری‬1‫ﺕ & ا
وا‬

Department/Unit Evaluator’s Appointing Authority’s ASM Signature and Date

Signature and Date Signature and Date ‫ت‬1$‫ة ا‬#‫ی دا‬$ & ‫ﺕ‬
V‫ری‬1‫\ ا;ض وا‬U‫ﺕ & ا‬ V‫ری‬1‫وا‬
V‫ری‬1‫ة وا‬$%‫ا‬/‫ة‬#‫ا‬$‫  ا‬. & ‫ﺕ‬

13 Revised 6/09