Page | 5
It is the responsibility of the employee to submit completed and signed documentation
to Human Resources by January 31st.
SUPERVISION / DIRECTION
Supervision/Direction received: Please select one of the following that best describes the type and amount of supervision that
your position receives.
My supervisor frequently checks my job activities.
I work alone on routine or regular work assignments and check with my supervisor on non-routine
assignments or when in doubt as to the correct procedures to follow.
I receive occasional supervision while working toward a definite objective that requires use of a wide range
of procedures. I plan, and/or determine specific procedures or equipment required to meet assigned
objectives, and I solve non-routine problems. I refer only unusual matters to my supervisor.
I work from broad policies and towards general objectives. I refer specific matters to superior(s) only when
interpretation or clarification of organizational policies is necessary.
I work from general directives or broadly defined missions of the organization.
From whom do you receive work assignments?
Name Title
Supervision/direction given: Do you directly supervise employees (including conducting performance evaluations)?
YES NO
Indicate the total number of employees supervised directly: and indirectly:
Supervision/direction given: Do you perform “Lead” duties? YES NO
List the employees you directly supervise or lead (include name, classification and status). If you supervise or lead more than
ten employees, you may list only the job titles and number of people supervised:
What type of supervision/lead do you provide? Please select all of the supervisory/lead duties you perform, the level of your
authority, and indicate whether you perform this activity for employees, non-employees (e.g. volunteers), or both.
STATUS
FTE = Full-time employee
P
T = Part-time/Intermittent employee/Student Worker
TEMP = Temporary or Contract employee
Job Title and Number of Staff Supervised
(direct or of lead)
FTE PT/TEMP
STUDENT
Direct Lead
Direct Lead
Direct Lead
Direct Lead
Direct Lead