"Self-appraisal Form - University of California Riverside"

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Self-Appraisal Form
EMPLOYEE INFORMATION
Name:
Title:
Dept.:
Eval Period: From
Through
SELF-APPRAISAL
This self-appraisal will be considered for your overall appraisal and will become an attachment to the Performance Appraisal.
Indicate “see attached” if more space is needed
1. Summarize your major accomplishments for this review period (such as proposals, assignments completed,
reports, presentations, significant results, etc.)
2. List any training programs, conferences, committee memberships or other educational activities in which you
have participated during this period.
a.
What problems and constraints influenced your work performance during the review period, if applicable?
b.
In your current position, what additional skills would be helpful in preparing you to do your job more effectively? How do
you plan to acquire them?
p. 1
Rev. 05/16/2012
Self-Appraisal Form
EMPLOYEE INFORMATION
Name:
Title:
Dept.:
Eval Period: From
Through
SELF-APPRAISAL
This self-appraisal will be considered for your overall appraisal and will become an attachment to the Performance Appraisal.
Indicate “see attached” if more space is needed
1. Summarize your major accomplishments for this review period (such as proposals, assignments completed,
reports, presentations, significant results, etc.)
2. List any training programs, conferences, committee memberships or other educational activities in which you
have participated during this period.
a.
What problems and constraints influenced your work performance during the review period, if applicable?
b.
In your current position, what additional skills would be helpful in preparing you to do your job more effectively? How do
you plan to acquire them?
p. 1
Rev. 05/16/2012
3. Goals and Objectives. (State specific and achievable goals/objectives you hope to achieve during the next
appraisal period.)
4. What other issues (which may include your working relationship with your supervisor) would you like to
discuss in the appraisal review discussion?
SIGNATURES
Employee
Signature:
Date:
Supervisor
I have read and discussed this self-appraisal with my employee and I understand its contents. My signature does not imply that I agree
or disagree with the contents.
Signature:
Date:
p. 2
Rev. 05/16/2012
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