Complete this form
before meeting with the employee. Have the employee complete a
copy of this form too. See
Getting
ready and
The Meeting.
During the interview, develop answers you both agree on. If you
can’t agree on an item, the supervisor’s assessment
should be put on the form. The employee should note his or her
disagreement in the comment section.
Performance Planning and Review
Name:
Title:
Supervisor:
Date:
For Review Period ___/___/___ to ___/___/___
In the left-hand column, list the skills required for the job.
See Skills and the Work description for some ideas about what
you might want to include. Then put an X in the column which describes
the employee’s performance of that skill the best.
________________________________________________________
Poor Needs Meets Very Good Outstanding
Improvement Requirements
________________________________________________________
Skills Required
________________________________________________________
________________________________________________________
________________________________________________________
________________________________________________________
________________________________________________________
________________________________________________________
In the left-hand column, list the goals for the period being
reviewed. Then put an X in the column that best describes how
well the goal was met.
Achievement of Goals
Goal Did Not Achieve Achieved Exceeded
1.______________________________________________________
2.______________________________________________________
3.______________________________________________________
4.______________________________________________________
5.______________________________________________________
Put an X in the column which best describes overall performance.
Poor Needs Meets Very Good Outstanding
Improvement Requirements
Overall Performance_________________________________________
List three to five goals for the coming review period. See Setting
goals.
Goals for the Coming Period:
1. ____________________________________________________
2. ____________________________________________________
3. ____________________________________________________
4. ____________________________________________________
5. ____________________________________________________
Check page one of this form to see what skills need to be improved.
Also, include any new skills that will need to be developed because
of changes in the work or to become better qualified.
Skills to be Developed:
_______________________________________________________
_______________________________________________________
_______________________________________________________
_______________________________________________________
The remaining sections should be filled out during the interview.
Career Goals:
_______________________________________________________
_______________________________________________________
_______________________________________________________
_______________________________________________________
What the Employee Will Do:
_______________________________________________________
_______________________________________________________
_______________________________________________________
_______________________________________________________
What the Company Will Do:
_______________________________________________________
_______________________________________________________
_______________________________________________________
_______________________________________________________
Employee’s Comments:
_______________________________________________________
_______________________________________________________
_______________________________________________________
_______________________________________________________
Employee’s Signature _____________________ Date ___________
Supervisor’s Signature _____________________ Date___________
