[pic] Self Appraisal Worksheet

|Employee Name: | |Review Period: | | to | |

Section I: GOALS AND OBJECTIVES REVIEW (Describe key goals/objectives and results for this appraisal cycle)

|Goals/Objective |Results |
|1 | | |
|2 | | |
|3 | | |
|4 | | |
|5 | | |

Section II: PERFORMANCE VALUES (Complete 4 of the 6) ▪ Accountability The degree to which the employee’s work behaviors demonstrate responsible personal and professional conduct, which contributes to the overall goals and objectives; understands how one's own actions relate to the college's and department’s strategic goals. Describe how you demonstrate performance value:

▪ Adaptability Responds to changing circumstances by being innovative and altering behavior to better fit different situations; learns new skills, performs work in different ways; professionally deals with personal discomfort in a changing work environment; willing to be flexible; remains calm in stressful situations. Describe how you demonstrate performance value:

▪ Communication Effective in all forms of communication required (oral, written, presentation). Listens effectively. Describe how you demonstrate performance value:

▪ Service Orientation Acts professionally and calmly at all times when interacting with others; consistently demonstrates concern and courtesy towards colleagues and customers; treats all people respectfully; takes personal responsibility for correcting problems; follows up with individuals to ensure satisfaction with the level of service they have received. Describe how you demonstrate performance value:

▪ Valuing Diversity Treats all individuals fairly and respectfully, works effectively with others, regardless of their background, position, or status; ensures that opportunities are equally available to all; respects different values and viewpoints. Describe how you demonstrate performance value:

▪ Working Collaboratively Works collegially with others, cooperating in both interpersonal and team relationships; fosters enthusiasm and maintains mutual trust, candor and respect with colleagues. Describe how you demonstrate performance value:

Section III: PERFORMANCE FACTORS (Complete 4 of the 7) ▪ Dependability/Attendance Reliable, forthright, and consistently available and punctual for all work activities. Describe how you demonstrate performance factor and if you would like to further develop this and how:

▪ Initiative Takes action to improve a situation without waiting for explicit instructions; recognizes and responds to opportunities in order to reach a goal; seeks new and improved techniques, solutions, and approaches to completing assignments. Describe how you demonstrate performance factor and if you would like to further develop this and how:

▪ Job Knowledge The degree to which the employee is skilled in job specific knowledge that is necessary to provide the appropriate quantity and quality of work in a timely and efficient manner. Describe how you demonstrate performance factor and if you would like to further develop this and how:

▪ Technology and/or Specialized Knowledge Demonstrates ability to use technology effectively and productively; continually updates skills, knowledge. Describe how you demonstrate performance factor and if you would like to further develop this and how:

▪ Problem-Solving Identifies and weighs options; asks pertinent questions; seeks clarification; makes sound decisions after reviewing all relevant information; anticipates and plans for potential problems; takes calculated risks; recognizes impact of solutions. Describe how you demonstrate performance factor and if you would like to further develop this and how:

▪ Time Management Organizes work effectively, works efficiently, and meets deadlines. Demonstrates ability to prioritize and adhere to guidelines/timelines where applicable. Describe how you demonstrate performance factor and if you would like to further develop this and how:

▪ Quality of Work Effectively produces a caliber of work consistent with standards; completes work thoroughly and accurately, pays attention to detail; contributes to the improvement of quality of services provided. Describe how you demonstrate performance factor and if you would like to further develop this and how:

Section IV: MANAGERIAL PERFORMANCE FACTORS (Complete 3 of the 4) (for Manager and Supervisor positions) ▪ Fiscal Management Understands the meaning and implications of key financial indicators; tracks and adheres to financial plan, makes sound decisions that consider cost/benefit; accurately estimates expertise levels, capital budgets and other factors; shows innovation in reducing expenses. Describe how you demonstrate performance factor and if you would like to further develop this and how:

▪ Leadership Creates a vision or goal for one’s work unit and communicates it in a way that motivates others to implement it; understands and leverages the organization’s structure and relationships; pursues organization support and resources; develops strategies to include divergent opinions and overcomes adversity; moves plans forward toward a specific course of action. Describe how you demonstrate performance factor and if you would like to further develop this and how:

▪ Program/Department Management Assumes overall responsibility for meeting performance goals/objectives and appropriate use of resources. Describe how you demonstrate performance factor and if you would like to further develop this and how:

▪ Staff Management Sets clear goals and expectations for staff; follows progress against goals; provides regular feedback; performs timely completion of performance appraisals; addresses performance issues promptly; fosters learning and professional development; provides public recognition of staff accomplishments; holds timely and productive staff meetings. Describe how you demonstrate performance factor and if you would like to further develop this and how:

SECTION V: OVERALL PERFORMANCE RATING (Please check appropriate rating that best describes your overall performance)

Significantly Exceeds Expectations Performance significantly exceeds position requirements.

Exceeds Expectations Performance meets and consistently exceeds position requirements.

Meets Expectations Performance meets position requirements.

Needs Improvement Performance meets some, but not all, position requirements.

Unsatisfactory Performance is significantly below position requirements.

SECTION VI: UPCOMING GOALS AND OBJECTIVES (Describe key goals/objectives and dates for upcoming appraisal cycle)

|Goals/Objectives |Target Date |
|1 | | |
|2 | | |
|3 | | |
|4 | | |
|5 | | |

SECTION VII: FUTURE DEVELOPMENT
What professional development activities/opportunities (i.e. training, special assignments, etc.) would you like to pursue during the next appraisal cycle that would enhance your job performance? (please attach additional page if needed)

SECTION VIII: SIGNATURE (Please sign, date, and forward to your supervisor)

_____________________________________ ______________
Employee Signature Date