"Administrative Staff Self Evaluation Form"

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SELF EVALUATION FORM
ADMINISTRATIVE STAFF
Date:__________
Name:_____________________________________________ Job Title:________________________________________
Department:____________________________ Immediate Supervisor/Title:______________________________________
Department Head/Title:__________________________________________ Review Period: ___Probationary
___Annual
INSTRUCTIONS: Please complete this form and provide a copy to your supervisor prior to the scheduled evaluation meeting with your
supervisor.
GOALS, OBJECTIVES AND PROJECTS FOR CURRENT EVALUATION PERIOD:
1.
GOAL/OBJECTIVE/PROJECT:_________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
Complete: ___Yes
___No
Date for Completion:________________________________________________
2.
GOAL/OBJECTIVE/PROJECT:_________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
Complete: ___Yes
___No
Date for Completion:_________________________________________________
3.
GOAL/OBJECTIVE/PROJECT:_____________________________________________________________________
__________________________________________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________
Complete: ___Yes
___No
Date for Completion:_________________________________________________
4.
GOAL/OBJECTIVE/PROJECT:__________________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________
__________________________________________________________________________________________
Complete: ___Yes
___No
Date for Completion:__________________________________________________
PERFORMANCE SUMMARY Please provide a summary of your performance addressing the following factors: initiative,
judgement, leadership, organizational skills, tasks accomplished and not accomplished, and your ability to relate to colleagues
and members of the campus community. This summary should also include an assessment of your contributions toward the
college’s overarching goals of providing and supporting a high quality liberal arts education.
____________________________________________________________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________
ESTABLISHING GOALS AND OBJECTIVES Please list the goals or objectives you would like to pursue in the upcoming
year.
1.
GOAL/OBJECTIVE:_____________________________________________________________________________
_____________________________________________________________________________________________
2.
GOAL/OBJECTIVE:_____________________________________________________________________________
_____________________________________________________________________________________________
3.
GOAL/OBJECTIVE:_____________________________________________________________________________
_____________________________________________________________________________________________
________________________________________
___________
Employee Signature
Date
02/02
SELF EVALUATION FORM
ADMINISTRATIVE STAFF
Date:__________
Name:_____________________________________________ Job Title:________________________________________
Department:____________________________ Immediate Supervisor/Title:______________________________________
Department Head/Title:__________________________________________ Review Period: ___Probationary
___Annual
INSTRUCTIONS: Please complete this form and provide a copy to your supervisor prior to the scheduled evaluation meeting with your
supervisor.
GOALS, OBJECTIVES AND PROJECTS FOR CURRENT EVALUATION PERIOD:
1.
GOAL/OBJECTIVE/PROJECT:_________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
Complete: ___Yes
___No
Date for Completion:________________________________________________
2.
GOAL/OBJECTIVE/PROJECT:_________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
Complete: ___Yes
___No
Date for Completion:_________________________________________________
3.
GOAL/OBJECTIVE/PROJECT:_____________________________________________________________________
__________________________________________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________
Complete: ___Yes
___No
Date for Completion:_________________________________________________
4.
GOAL/OBJECTIVE/PROJECT:__________________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________
__________________________________________________________________________________________
Complete: ___Yes
___No
Date for Completion:__________________________________________________
PERFORMANCE SUMMARY Please provide a summary of your performance addressing the following factors: initiative,
judgement, leadership, organizational skills, tasks accomplished and not accomplished, and your ability to relate to colleagues
and members of the campus community. This summary should also include an assessment of your contributions toward the
college’s overarching goals of providing and supporting a high quality liberal arts education.
____________________________________________________________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________
ESTABLISHING GOALS AND OBJECTIVES Please list the goals or objectives you would like to pursue in the upcoming
year.
1.
GOAL/OBJECTIVE:_____________________________________________________________________________
_____________________________________________________________________________________________
2.
GOAL/OBJECTIVE:_____________________________________________________________________________
_____________________________________________________________________________________________
3.
GOAL/OBJECTIVE:_____________________________________________________________________________
_____________________________________________________________________________________________
________________________________________
___________
Employee Signature
Date
02/02