Sample Performance Appraisal Form

MANASEGEOFREY - +255 785 65 2949. geofreymanase9@gmail.com DESIGNED SEPTEMBER 21, 2015 1
NAME OF THE COMPANY – ANNUAL PERFORMANCE APPRAISAL (REVIEW) FORM
STAFF PERFORMANCE APPRAISAL FORM (SUPERVISORY ROLE)
Appraisal Period From: Click here to
enter a date.
To: Click here to enter
a date.
Review date Click here to
enter a date.
Employee name:
Select name.
Employee number:
Designation:
Select Title.
Department:
Choose Department.
Work station:
Choose work station.
Mobile number:
Supervisor name:
Select name.
Supervisor title:
Select Title.
POLICY STATEMENT AND ANNUAL PERFORMANCE APPRAISAL INSTRUCTIONS
Policy Statement
Company name is committed to Staff Development and Performance Management that contributes to
development of the individual and hence of the Company. Annual performance appraisals evaluate the
employee’s performance relative to the Company, departmental and position competencies and agreed
performance goals and to outline any area requiring improvement or development. Performance appraisals
also assess the suitability of the employee for additional responsibilities, succession planning or promotion
and where applicable determine the employee’s eligibility for the purpose of salary/merit increment
progression.
Annual Performance Appraisal Instructions
This performance appraisal process is designed to evaluate an employee’s performance over a specified
period of time. When the process works well, the employee and his/her supervisor plan together to build on
strengths and develop those areas needing improvement. During the performance appraisal session, time is
set aside to:
1) Restate expectations about job responsibilities and performance standards
2) Evaluate job performance against previous expectations
3) Discuss future development opportunities and relate them to organizational needs
Supervisors: In evaluating an employee’s performance, you are to identify strengths and areas of
performance which require improvement. You are asked to provide examples of the employee’s performance
to illustrate the ratings you give. Examples based on your own observations work best. However, second
hand observations are permissible if you have verified the information. Such examples clarify your message.
Remember to use constructive feedback techniques. The goal is to increase performance, so feedback needs
to be carefully presented so that it is internalized and acted on. Ensure that you are recognizing strengths and
achievements, and not just documenting opportunities for improvement. Similarly, provide even your
strongest employees with ideas for areas where they can grow.
Employees: The more involved you are in the performance appraisal session, the more effective the process
is likely to be. Be prepared by collecting evidences of your comments as you have filled the appraisal form.
Consider performance over the entire year, reviewing documented feedback, goals and objectives and other
sources of performance information.

The performance appraisal process should include the following steps:
 The employee completes the blue-shaded items in this form and provides the form in soft-copy to
their supervisor at least 2 weeks before the planned meeting date.
 The supervisor then completes the green-shaded items in this form, without editing the employee’s
content in the blue-shaded areas. The feedback should take into account the employee’s self-review,
any third party input, the job description, documented objectives, feedback documented over the
course of the year, and other sources of information. Supervisors may also find it helpful to access
previous reviews and the competency and performance management reference documents.
 The employee and their supervisor meet to discuss the review, and edit the form (with objectives,
learning plans, additional notes, etc.) after that meeting.
 The review form is signed by the employee and their supervisor, and then by the next line of
management.
 Provide copy of signed Staff Performance Appraisal to employee.
 Provide signed Staff Performance Appraisal in the Human Resource Department to be kept in the
employee’s personnel file.
MAJOR RESPONSIBILITIES
(This is what the employee does)
This section is all about what the employee contributed last year and in the sections that follow you will also
provide feedback on how the employee contributed. This section of the Performance Review form is used
to record the three to five major activities or goals that the employee is responsible for in their job as well as
the evaluation criteria for these. The major activities typically reflect duties described in the job description
and/or performance goals. Evaluation criteria encompass such standards as impact, timeliness, cost
effectiveness, client satisfaction, accuracy, consistency, etc. During regular review period, the manager and
staff member are encouraged to review progress in meeting identified goals or activities, and may decide to
revise, add, or delete any of these in order to best meet changing organizational needs.
Employee: Enter information for each of your objectives for the past year, including both the objective and
the measures as agreed to with your supervisor. Include any updates/changes that were agreed to over the
course of the year. Provide comments on the results achieved as well as any important context.
Supervisor: Review the information provided by the employee. Add comments on achievement and results,
context and challenges, and/or feedback for the employee. Provide a rating for achievement against each
objective (substantiated by your comments). Provide an overall rating. The overall rating should be a
summary, informed by your judgment of the relative importance of each objective, the results achieved, and
the context; it is not necessarily an “average” of the ratings for each objective.
Performance Ratings:
Outstanding Consistently far exceeds expectations.
Above Expectations Consistently meets and frequently exceeds expectations
Meets Expectations Consistently meets and occasionally exceeds expectations.
Below Expectations Occasionally fails to meet expectations. Improved performance by the next
appraisal period is needed.

“Failure to plan, is to plan to failure”
Needs Improvement Frequently fails to meet expectations. Immediately improvement is needed.
Objectives/Goals Performance Standards/Measures
1. Employee click here to enter
agreed objective number one.
Employee click here to enter agreed performance standard for objective
number one.
Employee click here to enter your comments on the results or achievements on objective number one.
Supervisor click here to enter your comments about employee’s results or
achievements on objective number one.
-Performance Rate-
agreed objective number two.
number two.
Employee click here to enter your comments on the results or achievements on objective number two.
achievements on objective number two.
-Performance Rate-
agreed objective number three.
number three.
Employee click here to enter your comments on the results or achievements on objective number three.
achievements on objective number three.
-Performance Rate-
agreed objective number four.
number four.
Employee click here to enter your comments on the results or achievements on objective number four.
achievements on objective number four.
-Performance Rate-

agreed objective number five.
number five.
Employee click here to enter your comments on the results or achievements on objective number five.
achievements on objective number four.
-Performance Rate-
Supervisor click here to enter your overall summary or comments on Employee’s
major responsibilities.
-Performance Rate-
Performance Competencies and Organizational Values (Skills and behaviors)
This section is about how the employee contributed last year and how the employee’s behaviours align with
the Company name competencies and organizational values. At the beginning of the review period, the
manager and employee are responsible for reaching a shared understanding of the key skills and behaviors
as they relate to the individual’s job description. While the employee will be evaluating him or herself
regarding the key skills and behaviors, the manager is ultimately responsible for assessing the staff member’s
performance against the agreed upon performance expectations and reviewing the assessment with the
individual.
Employees: Provide your comments on the behaviors you demonstrate under each competency. Provide
examples where possible.
Supervisors: Review the information provided by the employee and provide your feedback. Select the
level of each competency demonstrated by the employee.
Ensure that your comments cover:
 Examples of behaviours supporting your rating;
 Any measures or evidence linked to these competencies (such as the extent to which a
manager completes high quality performance reviews for staff, or effective budget/variance
management);
 Particular strengths, specifically relating to competencies;
 Opportunities for improvement (phrased as constructive feedback) specifically relating to
competencies; and
 Whether, on the whole, the employee is displaying the target level (or higher) for each
competency.
Note: Ensure that you are recognizing strengths and achievements, and not just documenting opportunities
for improvement. Similarly, provide even your strongest employees with ideas for areas where they can
grow. Remember to use Constructive Feedback techniques.

Competency/Skills Performance Measures/Standards
Functional(Job) or Technical
Knowledge/skills
 Demonstrates expertise in skill and knowledge within areas relevant to
one’s own function or work group. Applies knowledge and skills to
meet job requirements
 Applies current best practices in discipline or specialty area.
 Stays aware of major developments in discipline or specialty area.
 Recognized by customers and team members for functional knowledge
and skills.
 Serves as a resource for others regarding major developments in
discipline or specialty area, and facilitates sharing of methods and
knowledge.
Employee click here to enter your comments on the above mentioned skill or competency.
Supervisor click here to enter your comments on the how employee demonstrated
above skill or competency.
-Performance Rate-
-Performance Rate-
-Performance Rate-
-Performance Rate-
-Performance Rate-
Problem Solving and
Creativity
 Considers multiple sides of an issue. Weighs consequences before
making final decision.
 Not discouraged by ambiguous situations. Is open to new ideas and
processes. Adjusts approach to achieve results.
 Makes informed decisions based on available and hard to find
information and addresses problems in ways that lead to innovative
solutions. Utilizes information that is relevant, current and clear.
 Creates new ideas and processes despite initial ambiguity of the
situation; modifies approach to achieve results in changing situations.
 Identifies and analyzes problems; formulates alternative solutions;
takes or recommends appropriate actions; follows up to ensure
problems are resolved.
above skill or competency.
-Performance Rate-
-Performance Rate-
-Performance Rate-
-Performance Rate-
-Performance Rate-
Customer service/Service to
others
 Dedication to meeting the expectations and requirements of internal
and external customers; acts with customers in mind; establishes and
maintains effective relationships with customers and gains their trust
and respect; goes above and beyond to anticipate customer
circumstances, problems, needs, and expectations and respond
accordingly. Follows up with customers to ensure satisfaction.

 Keeps customers informed by providing status reports and progress
updates as well as attending their needs on time.
 Maintains supportive relationships with customers. Uses initiative to
improve outcomes, processes, or measurements.
 Seeks opportunities to improve the products and/or services to meet
customer needs.
above skill or competency
-Performance Rate-
-Performance Rate-
-Performance Rate-
-Performance Rate-
Quality of work  Accurately and carefully follows process/procedures for completing
work. The work is smart and attractive.
 Ensures a high-quality output of work (resulting in minimal
acceptable/zero errors)
 Attentive to all details and aspects of a job or process to ensure a
complete, high quality output.
-Performance Rate-
-Performance Rate-
-Performance Rate-
Communication and
interpersonal skills
 Is able to effectively communicate and to influence others in order to
meet organizational goals; shares information openly; relates well to
all kinds of people; is able to speak well and write effectively.
Encourages direct reports to communicate consistently, clearly and
professionally.
 Uses diplomacy and tact; can diffuse high-tension situations
comfortably.
 Listens carefully to others, asks questions for clarification, and ensures
message is understood.
 Tailors communication style to the needs of each situation and
audience.
-Performance Rate-
-Performance Rate-
-Performance Rate-
-Performance Rate-

Time and Task Management  Adheres to work schedule and stays productive and focused on
assigned tasks during work hours, absences are minimized and follows
work unit rules for time and attendance.
 Completes required volume of work by established deadlines and
sufficiently prioritizes tasks and organizes work flows. Adapts to work
changes and re-prioritizes appropriately.
 Provides sufficient updates to supervisor and other relevant parties on
the status of assigned work. Appropriately escalates work concerns to
management when warranted.
 Does not require an excessive degree of oversight or correction. Does
not place an undue burden on supervisor or colleagues to complete
assigned tasks.
-Performance Rate-
-Performance Rate-
-Performance Rate-
-Performance Rate-
Commitment, accountability
and reliability
 Demonstrates patience and dedicated to achieve organizational goals
with available resources even in the challenging environments.
 Demonstrates firm attitude and willingness to take time and energy to
develop the company and attain excellence in the career and
professional development.
 Provide reasonable account for his/her activities, accept responsibility
for them, and disclose the results in a transparent manner. It also
includes the responsibility for money or other entrusted properties.
 Proves to be reliable, dependable, predictable and trustworthy to
discharge duties in the job description or any other assigned and
accepted job as for accuracy, speed, honesty and achievement.
-Performance Rate-
-Performance Rate-
-Performance Rate-
-Performance Rate-
Integrity and Ethics  Behaves and expresses oneself in an open and honest manner; is
consistent in all cases with what he/she says and does; appropriately
handles difficult situations.
 Dedicated to uphold oneself to consistently moral and professional
ethical standards; having strong moral principles and moral
uprightness.
 Seeks updated professional ethical standards and knowledge.

Note: In case of any query related to Performance Review or Human Resource in general you can at
any time seek information from Human Resource Department. Human Resource Department is
-Performance Rate-
-Performance Rate-
-Performance Rate-
Respect  Treats all customers, suppliers and employees with dignity, equality
and consideration and committed to foster environment of diversity
that respects and appreciates individual differences.
 Regards company properties and environment with acceptable esteem.
 Cultivate a behavior that increase and protect company’s reputation.
-Performance Rate-
-Performance Rate-
-Performance Rate-
Teamwork/Collaboration  Shares information, knowledge and resources with others to promote
positive and collaborative work relationships. Work with internal and
external clients as a team.
 Willingness and positively receive help, correction, instruction and
improvement
 Willingness to help others when asked.
 Attitude to seek and identify opportunity to help and develop others
even when not asked.
-Performance Rate-
-Performance Rate-
-Performance Rate-
-Performance Rate-
EMPLOYEE DISCUSION QUESTIONS
This section is to be filled with the employee. Supervisor will review the answers and discuss them with the
employee during performance review meeting. Aim is to allow supervisor to get deep and broader position
of employee in regard to job or his/her career; with the aim to facilitate and boost professional development
of the employee.
1. Has the past year been good/bad/satisfactory or otherwise for you, and why?
Employee click here to enter your answer in respect to the above question.
2. What do you consider to be your most important achievements of the past year?

3. What do you like and dislike about working for this Company?
4. What elements of your job do you find most difficult?
5. What elements of your job interest you the most?
6. What do you consider to be your most important aims and tasks in the next year?
7. What action could be taken to improve your performance in your current position by you, and
your boss? (This can be as simple as reading a book, serving on a team, observing someone who does
it well, asking for feedback on a behavior that you’re trying to change, etc.)
8. What sort of training/experiences would benefit you in the next year? Not just job-skills - also your
natural strengths and personal passions you'd like to develop - you and your work can benefit from
these.
Supervisor click here to enter your overall summary or comments on Employee’s
in respect to competencies or answers to discussion questions.
-Performance Rate-

SETTING GOALS FOR THE NEXT YEAR (REVIEW PERIOD)
This section is to be completed by the employee and then discussed and agreed upon with the manager or
supervisor. Identify objectives that will be undertaken in this coming year, along with measures, and an
appropriate timeline and completion date for each objective. When describing the measures, be sure to
consider how you will measure achievement for each objective at the Year End Performance Review. Keep
in mind that during the review period, goals and evaluation criteria may be revised, added, or deleted in order
to best meet changing organizational needs. The measures for each objective should be specific, observable,
and indicate progress or final objective completion.
When identifying objectives, remember to write them as SMARTER goals. Objectives should be:
 Specific (specify a single result that is precise and observable)
 Measurable (written in observable terms specifying a quantifiable desired outcome where possible);
 Achievable (realistic and attainable, but represents an appropriate level of challenge)
 Relevant (directly related to the employee’s responsibilities and within his/her control)
 Time-based (time limited and progress towards the desired outcome can be reported)
 Ethical (that respect and meet ethical standards)
 Recorded (Goals, executions process and achievement should be recorded)
Objective Measures/Standards Timeline (Deadline)
objective number one for the next
review period.
Employee click here to enter measures
or standard of the objective one.
Employee click here
to enter deadline to
accomplish objective
one.
objective number two for the next
review period.
or standard of the objective two.
Employee click here
two.
objective number three for the next
review period.
or standard of the objective three.
Employee click here
three.
objective number four for the next
review period.
or standard of the objective four.
Employee click here
four.

objective number five for the next
review period.
or standard of the objective five.
Employee click here
five.
GROWTH AND DEVELOPMENT PLAN
This section is to be completed by employee, discussed and agreed upon with the supervisor. Identify the
learning goals and associated key learning activities, appropriate timeline, and completion date. The goals
you create should be SMARTER goals (Specific, Measureable, Achievable, Relevant, Time-based, Ethical
and Recorded), and remember to focus on a few areas where further development can have a more significant
impact on the employee’s performance.
Learning Goals: Identify the skills and competencies that will be the focus of learning for the upcoming
year. When identifying a goal, think of the desired expected learning or final outcome.
Type of learning goal: Identify whether a goal is Operational (Op) or Developmental (Dev) in nature.
 Operational goals: On-the-job training and/or classroom training that enables trainees to acquire
the knowledge & skills necessary to reach the level of proficiency required to perform the full
duties of a position.
 Developmental: Any learning activity to improve abilities, capabilities, competencies and attitudes
in order to meet corporate needs.
Key Learning Activities: Identify how the learning will take place. For example: specific developmental
assignments, special projects, coaching/mentoring, acting assignments, reading, video, job shadow,
classroom training, etc.
Timeline and Goal Completion Date: Identify when the specific learning activities will take place and
estimate a completion date for each learning goal.
Learning goals
Type Proposed Learning Strategy
Op Dev Learning Activities Timeline (Completion date)
1. Employee click here to
enter learning objective
one.
Employee click here to enter
learning activities for objective
one.
completion date for learning
objective one.
two.
two.
objective two.
three.
three.
objective three.
four.
four.
objective four.

fully committed to provide support to individual professional development and the company at
large.
Human Resource Department Operating Principles
 We include and excel together  We imagine and innovate
 We focus on services  We are accountable to each other
 We simplify
five.
five.
objective five.
SIGNATURES
For Employee:
I acknowledge that I have received the review feedback, and that I have had the opportunity to share my
perspective. I understand the Objectives and Learning Plan. By signing this form, I confirm that I have
discussed my review in detail with my supervisor. Signing this form does not necessarily indicate that you
agree with the evaluation.
Signature: Date: Click here to enter a date.
Name: Select name. Title: Select Title.
For Supervisor:
I have discussed the contents of this Performance Plan – Year-End Performance Review with the employee
in a review meeting and stand behind this review and my feedback. I will provide ongoing performance
feedback to the employee and regularly review progress with the employee. I agree to and support the
proposed Objectives and Learning Plan
For Next Line of Management:
To enter comments from next line of management click here.

Sample Performance Appraisal Form

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