Self-evaluation Form - University of Kentucky

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SELF-EVALUATION FORM
Demographic Data
Last 4
XXX - XX -
Employee Name
SSN #
Last
First
MI
Supervisor
Name
Department
Job Title
Review Period
through
Type of Evaluation (select one):
Mid-Year
Annual
Why should I do a self-evaluation?
This form is an evaluation tool for enhancing feedback and performance success. Conducting an annual or mid-year self-evaluation will
allow you to provide information to your supervisor about your performance and shed light on your accomplishments and goals during
this evaluation period. This tool may also help new supervisors get to know their staff better. Knowing employees is a basic
requirement for the successful management of a work team.
Job Function Performance
How I believe I performed my Essential Functions, overall:
Accomplishments
Accomplishments and Essential Functions I believe I have handled well this past year:
SELF-EVALUATION FORM
Demographic Data
Last 4
XXX - XX -
Employee Name
SSN #
Last
First
MI
Supervisor
Name
Department
Job Title
Review Period
through
Type of Evaluation (select one):
Mid-Year
Annual
Why should I do a self-evaluation?
This form is an evaluation tool for enhancing feedback and performance success. Conducting an annual or mid-year self-evaluation will
allow you to provide information to your supervisor about your performance and shed light on your accomplishments and goals during
this evaluation period. This tool may also help new supervisors get to know their staff better. Knowing employees is a basic
requirement for the successful management of a work team.
Job Function Performance
How I believe I performed my Essential Functions, overall:
Accomplishments
Accomplishments and Essential Functions I believe I have handled well this past year:
Last Name: _______________________
Last Four of SSN: __________________
Areas for Improvement
Job performance areas that I could use improvement or I need help in:
Goals and Objectives
These are goals and objectives I would like to work on in the upcoming year::
Support
This is the way I develop best (examples: one-on-one training, group workshops, instructional materials only, etc.)
The support I need to improve my job performance and development (examples: opportunities to serve on department/University
committees, time to attend off-campus training, etc.):
Last Name: _______________________
Last Four of SSN: __________________
Job-Related Development
I have participated in the following job-related activities, workshops or seminars in the past year:
I would like to participate in the following type(s) of job-related activities, workshops or seminars in the upcoming year:
Department
I have the following suggestions for improving departmental effectiveness:
Employee Signature: _______________________________________________________
Date:
____/____/_____
Supervisor Signature: ______________________________________________________
Date:
____/____/_____
I would like a copy of this Self-Evaluation Form attached to the Performance Evaluation Form and placed in my
personnel record at Human Resources:
Yes
No

Download Self-evaluation Form - University of Kentucky

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