Administrative and Professional Faculty
SELF-ASSESSMENT
1
Evaluation plans must require that evaluative input be provided by the faculty member in the form of a self-
assessment. The self-assessment must include analysis of activities within each performance domain as well as
progress toward achievement of annual objectives. (VCCS Policy: 3.6.1.4.a.vi.)
Name of Faculty Member:
Position #:
Title:
Date:
Faculty Designation (select all that apply):
First Year Administrative Professional
Faculty Rank:
Status:
One-year appointment Multi-year appointment
Name of Faculty Member’s Supervisor:
Instructions: Please provide a self-assessment of your work/job related activities within each of the performance
domains and annual objectives. Be sure to include supporting information in the narrative sections or attach the
agreed upon documentation.
Performance Domains
I. Core Responsibilities (VCCS Policy: 3.6.1.4.a.ii)
Narrative (include areas of success, opportunities for improvement/learning and areas of concern, where applicable):
II. Non-Routine & Strategic Responsibilities (VCCS Policy: 3.6.1.4.a.ii)
Narrative (include areas of success, opportunities for improvement/learning and areas of concern, where applicable):
III. College and Community Service (VCCS Policy: 3.6.1.4.a.ii)
Narrative (include areas of success, opportunities for improvement/learning and areas of concern, where applicable):
IV. Professional Development & Growth (VCCS Policy: 3.6.1.4.a.ii)
Narrative (include areas of success, opportunities for improvement/learning and areas of concern, where applicable):
V. Management Effectiveness (if required) (VCCS Policy: 3.6.1.4.a.iii)
Narrative (include areas of success, opportunities for improvement/learning and areas of concern, where applicable):
VI. Additional Performance Domains (as approved by Supervisor)
Narrative (include areas of success, opportunities for improvement/learning and areas of concern, where applicable):
Administrative and Professional Faculty
SELF-ASSESSMENT
2
Annual Objectives
I. Objective #1 (VCCS Policy: 3.6.1.4.b)
Narrative (include your assessment of progress towards completion):
II. Objective #2 (VCCS Policy: 3.6.1.4.b)
Narrative (include your assessment of progress towards completion):
III. Objective #3 (VCCS Policy: 3.6.1.4.b)
Narrative (include your assessment of progress towards completion):
IV. Objective #4 (VCCS Policy: 3.6.1.4.b)
Narrative (include your assessment of progress towards completion):
V. Objective #5 (VCCS Policy: 3.6.1.4.b)
Narrative (include your assessment of progress towards completion):
OTHER COMMENTS OR NOTES (i.e., general efforts, outcomes, and professional behaviors, etc.):
Supporting documentation attached
Signature indicates all parties have discussed this Self-Assessment
Employee Signature Date
Supervisor Signature Date