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Performance Evaluation Form

Employee Code : Department :

Employee Name : Designation :
Date of Joining : Promotion
Details :
Qualification : Location :
Assessment Year : ------- to -------- Employment Status :

Part A:

Please assess your performance in the following areas in terms of your current role
requirements based on the ratings,
Exceeds Expectations – (4) Meets Expectations – (3)
Meets Minimal Requirements – (2) Unable to meet Requirements – (1)

Self Superviso
Appraisa r’s Justificatio
Rating Factors
l Appraisal n
Rating Rating
Personal Factors
Personal Traits
V – Versatility
I – Interaction with staff members
B – Building Company image
H – Honesty
A – Accountability
General Attitude
1. Punctuality
2. Attendance
3. Personal appearance
4. Communication skills
5. Problem solving/ Decision making
6. Striving for new knowledge
7. Self discipline
8. Diplomacy
9. Commitment to work
Professional Factors
1. Professional knowledge
2. Business related knowledge
3. Efforts @ Self development
Part B:

1) Please list the major responsibilities of your job in order of importance.

2) Please specify the major skill sets required to carry out your responsibilities

3) Please state the Additional activities you have involved related to your job in the review

4) What additional responsibilities you would like to take in the next year?

5) What motivates you,

a) Increment d) Recognition
b) Secure Employment e) Creative and Challenging work
c) Promotion f) Training and Development

6) What elements of your job interest you the most and why?

7) What elements of your job do you find most difficult and why?
8) Is there any Grievance which has affected your ability and efficiency, that you wish to
bring to the notice of the Management? (Please do not hesitate, if genuine, the same will
be looked into)

9) Your goal in the Organisation in near future.

By 2011 2012 2013

10) What sort of training/experience would benefit you in the next year?

Employee Signature
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