Professional UUP Staff
Performance Review Program
Name of Employee: _____________________________________________________
Job Title: ______________________________________________________________
Period of time covered by this evaluation: July 1, __________ to June 30, __________
Part I: Performance Review
(Completed by Supervisor Based on Last Year’s Performance Program)
Effectiveness in Performance:
(As demonstrated, for example, by success in carrying out assigned duties and responsibilities, efficiency,
productivity, and relationship with colleagues).
Exceptional Highly Effective Effective & Competent Needs Improvement Unsatisfactory
Mastery of Specialization:
(As demonstrated, for example, by degrees, licenses, honors, awards, and reputation in professional field).
Exceptional Highly Effective Effective & Competent Needs Improvement Unsatisfactory
Professional Ability:
(As demonstrated, for example, by invention or innovation in professional, scientific, administrative, or technical
areas; i.e. development or refinement of programs, methods, procedures, or apparatus).
Exceptional Highly Effective Effective & Competent Needs Improvement Unsatisfactory
Effectiveness in University Service:
(As demonstrated, for example, by such things as college and University public service, committee work, and
involvement in college or University related student or community activities).
Exceptional Highly Effective Effective & Competent Needs Improvement Unsatisfactory
U
n
s
a
t
i
s
f
a
c
t
o
r
y
U
n
s
a
t
i
s
f
a
c
t
o
r
y
U
n
s
a
t
i
s
f
a
c
t
o
r
y
U
n
s
a
t
i
s
f
Continuing Growth:
(As demonstrated, for example, by continuing education, participation in professional organizations, enrollment in
training programs, research, improved job performance and increased duties and responsibilities).
Exceptional Highly Effective Effective & Competent Needs Improvement Unsatisfactory
1. Employee Strengths or Positive Accomplishments:
U
n
s
a
t
i
s
f
a
c
t
o
r
y
2. Employee Challenges or Areas for Development:
3. General Comments about Employee Performance:
In general has employee’s overall performance been satisfactory?
Yes No
If no is checked, the employee has the right to appeal under appendix A-28.
Employee Initials: ______
Part II: Performance Plan for the Upcoming Year
(Completed Jointly by Supervisor and Employee)
This section is basically the job description for this individual for the next year. Overall
satisfactory performance is evaluated from this list.
A change in responsibilities during the year requires a revised Performance Plan.
1. List Core Duties:
2. List Priority or Special Projects:
3. List Specific Areas for Improvement or Growth:
Acknowledgment
Immediate Supervisor Signature:_______________________________ Date: ___________
(Acknowledges that Supervisor involved employee and reviewed results with employee.)
Secondary Supervisor Signature: ______________________________ Date: ___________
(If applicable)
Secondary Supervisor Comments: _____________________________________________
____________________________________________________________________________
____________________________________________________________________________
I understand that I have a right to submit a letter stating where I disagree with the evaluation.
Employee Signature: _________________________________________ Date: ___________
(Acknowledges only that the evaluation was reviewed with employee, not employee agreement.)
Management/Confidential Signature: ____________________________ Date: ___________
(Acknowledges agreement with Immediate Supervisor Recommendations.)
click to sign
signature
click to edit
click to sign
signature
click to edit
click to sign
signature
click to edit
click to sign
signature
click to edit