"Performance Evaluation Form - University of Kentucky"

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PERFORMANCE EVALUATION FORM
Demographic Data
Last 4
PID
SSN
Employee Name
First
Last
MI
Supervisor
Name
Department
Department Number
Position Number
Job Title
Review Period
through
Type of Evaluation (select one):
Mid-Year
Annual
Performance Data
Please complete the following information with as much detail as possible.
1. Essential Functions:
Job Standards:
PERCENT
multiplied by
RATING
equals
TOTAL RATING
0.00
Rating Scale: 1=Rarely Met Job Standards 2=Sometimes Met Job Standards 3=Met Job Standards 4=Occasionally Exceeded Job Standards
5=Consistently Exceeded Job Standards and/or Performed Significant Assignments in Addition to Regular Essential Functions
Comments (required):
PERFORMANCE EVALUATION FORM
Demographic Data
Last 4
PID
SSN
Employee Name
First
Last
MI
Supervisor
Name
Department
Department Number
Position Number
Job Title
Review Period
through
Type of Evaluation (select one):
Mid-Year
Annual
Performance Data
Please complete the following information with as much detail as possible.
1. Essential Functions:
Job Standards:
PERCENT
multiplied by
RATING
equals
TOTAL RATING
0.00
Rating Scale: 1=Rarely Met Job Standards 2=Sometimes Met Job Standards 3=Met Job Standards 4=Occasionally Exceeded Job Standards
5=Consistently Exceeded Job Standards and/or Performed Significant Assignments in Addition to Regular Essential Functions
Comments (required):
Last Name: _______________________
Last Four of SSN: __________________
2. Essential Functions:
Job Standards:
PERCENT
multiplied by
RATING
equals
TOTAL RATING
0.00
Rating Scale: 1=Rarely Met Job Standards 2=Sometimes Met Job Standards 3=Met Job Standards 4=Occasionally Exceeded Job Standards
5=Consistently Exceeded Job Standards and/or Performed Significant Assignments in Addition to Regular Essential Functions
Comments (required):
3. Essential Functions:
Job Standards:
PERCENT
multiplied by
RATING
equals
TOTAL RATING
0.00
Rating Scale: 1=Rarely Met Job Standards 2=Sometimes Met Job Standards 3=Met Job Standards 4=Occasionally Exceeded Job Standards
5=Consistently Exceeded Job Standards and/or Performed Significant Assignments in Addition to Regular Essential Functions
Comments (required):
Last Name: _______________________
Last Four of SSN: __________________
4. Essential Functions:
Job Standards:
PERCENT
multiplied by
RATING
equals
TOTAL RATING
0.00
Rating Scale: 1=Rarely Met Job Standards 2=Sometimes Met Job Standards 3=Met Job Standards 4=Occasionally Exceeded Job Standards
5=Consistently Exceeded Job Standards and/or Performed Significant Assignments in Addition to Regular Essential Functions
Comments (required):
5. Essential Functions:
Job Standards:
PERCENT
multiplied by
RATING
equals
TOTAL RATING
0.00
Rating Scale: 1=Rarely Met Job Standards 2=Sometimes Met Job Standards 3=Met Job Standards 4=Occasionally Exceeded Job Standards
5=Consistently Exceeded Job Standards and/or Performed Significant Assignments in Addition to Regular Essential Functions
Comments (required):
Last Name: _______________________
Last Four of SSN: __________________
Overall Rating
0.00
Add up all TOTAL RATING scores to determine the OVERALL RATING:
Supervisor Comments:
Employee Comments:
Attachments:
Self-Evaluation
Performance Improvement Plan*
*A rating of 1 or 2 for any Essential Function requires the completion of a Performance Improvement Plan by the supervisor and the employee.
Attach a copy of Sections One and Two of the Performance Improvement Plan to this Performance Evaluation Form and forward to Human
Resources.
**
Employee Signature: _____________________________________________________________
Date: _____/_____/______
Immediate Supervisor Signature: ____________________________________________________
Date: _____/_____/______
Next Level Supervisor Signature: ____________________________________________________
Date: _____/_____/______
Note: When the Performance Evaluation form is completed and signed, provide a copy to the employee, retain a copy for
department file, and send original to Human Resources Records, Room 21 Scovell Hall, 0064.
** Employee’s signature does not eliminate the right to address questions or concerns about the content of the evaluation through the appropriate departmental chain of
command.
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