STATE OF ARKANSAS
PERFORMANCE EVALUATION PLAN RATING FORM
Agency/Institution
Arkansas Tech University
Date of Evaluation
Employee's Name
Tech ID Number
Position Title
Position Number
Rater's Name
Tech ID Number
Rating Period From
To
Performance Categories
U-Unsatisfactory:
an overall performance of duties that is unacceptable in quality, accuracy, and timeliness
S-Satisfactory:
an overall evaluation which demonstrates competency in the performance of the duties
and responsibilities of the job
AA-Above Average
E-Exceeds Standards:
an overall evaluation which demonstrates performance of the duties and responsibilities
of the job at a level which is above the satisfactory level of performance
an overall evaluation which demonstrates performance of the duties and responsibilities
of the job at a level exceeding that of an above average evaluation
In the appropriate columns below, list Numbers, Duty Area, and Performance Categories from the succeeding
pages (use separate sheet if necessary).
#
DUTY AREA
PERFORMANCE
CATEGORY
OVERALL PERFORMANCE EVALUATION
PERFORMANCE EVALUATION RATING FORM
(Attach to Front Page as needed)
Employee's Name
Tech ID Number
Rating Period
to
Rater's Name
#
TASKS ASSIGNED
DUTY AREA
PERFORMANCE INDICATOR
PERFORMANCE EVALUATION RATING FORM
(Attach to Front Page as needed)
Employee's Name
Tech ID Number
Rating Period
to
Rater's Name
#
TASKS ASSIGNED
DUTY AREA
PERFORMANCE INDICATOR
PERFORMANCE EVALUATION RATING FORM
(Attach to Front Page as needed)
Employee's Name
Tech ID Number
Rating Period
to
Rater's Name
#
STANDARD STATEMENTS
Weight
Value
U
S
AA
E
Total
%
2
3
4
5
% x Points
=Total
1
STANDARD
RESULTS
2
STANDARD
RESULTS
PERFORMANCE EVALUATION RATING FORM
(Attach to Front Page as needed)
Employee's Name
Tech ID Number
Rating Period
to
Rater's Name
#
STANDARD STATEMENTS
Weight
Value
U
S
AA
E
Total
%
2
3
4
5
% x Points
=Total
3
STANDARD
RESULTS
4
STANDARD
RESULTS
PERFORMANCE EVALUATION RATING FORM
(Attach to Front Page as needed)
Employee's Name
Tech ID Number
Rating Period
to
Rater's Name
#
STANDARD STATEMENTS
Weight
Value
U
S
AA
E
Total
%
2
3
4
5
% x
Points
=Total
5
STANDARD
RESULTS
6
STANDARD
RESULTS
PERFORMANCE EVALUATION RATING FORM
(Attach to Front Page as needed)
Employee's Name
Tech ID Number
Rating Period
to
Rater's Name
#
STANDARD STATEMENTS
Weight
Value
U
S
AA
E
Total
%
2
3
4
5
% x Points
=Total
7
STANDARD
RESULTS
Unsatisfactory = 3.00-3.66 Satisfactory = 3.67-3.99 Above Average = 4.00-4.33 Exceeds Standards = 4.34-5.00
TOTAL PERFORMANCE CATEGORY =
PERFORMANCE EVALUATION RATING FORM
Employee's Name
ID Number
This section is to be completed when Standards are established at beginning of the rating period.
These standards were established in consultation with the employee named above.
Supervisor's Signature
Date
______________________
I have reviewed these standards and understand my performance will be measured against them.
Employee’s Signature
Date
I have reviewed these standards and agree that they are appropriate for the position.
Reviewing Official
Date
This section is to be completed at conclusion of the rating period.
My supervisor and I have reviewed my performance evaluation. My comments on the evaluation are as follows:
(Additional pages may be attached if necessary.)
Employee's Signature
Date
(NOTE: Signature does not necessarily mean agreement)
My employee and I have reviewed the employee's evaluation and all attachments.
Supervisor's Signature
Date
I have reviewed the employee's performance evaluation and all attachments.
Reviewing Official
Date