1. UFP Technologies Goal-Setting & Self-Assessment Form: Tier 2 - 2014
Associates
Purpose: This form is intended to provide the opportunity for managers and associates to determine the goals for the upcoming year, identify any
changes to goals mid-year, and for associates to assess their performance at year-end.
Parts A & B - Strategic & Developmental Goal-Setting:
Planning: Enter your strategic and developmental goals for the upcoming year. Goals are to be written using the S.M.A.R.T. Method. Set goals that
are:
S Specific M Measurable A Attainable R Relevant T Timely
Submit to your manager for review by Feburary 15, 2014. If applicable, update your goals per your manager’s feedback. Minimum amount of
goals: 1 strategic & 1 developmental. Maximum amount of goals: 3 strategic and 1 developmental.
Check-In: Meet with your manager to discuss any changes, progress, and/or updates to your goals. If applicable, update your goals per your
discussion. Submit to your manager by August 30, 2014.
Assessment: Provide feedback on the status of your goals, and choose the applicable rating (All goals must be rated) for each goal per the
review scale below:
Exceptional (5):
Performance far exceeded expectations and position requirements. The highest level
of job performance was exhibited. All goals and objectives were exceeded.
Exceeds Expectations (4):
Performance consistently exceeded the standard level. Job performance was clearly
more than satisfactory, surpassing position requirements. Accomplished all goals and
objectives, with most being exceeded.
Meets Expectations (3):
Performance was solid and position requirements were consistently fulfilled. Most
goals and objectives were met, with some being exceeded.
Improvement Needed (2):
Performance was inconsistent with regards to satisfying job requirements, and
improvement is needed in multiple areas. Multiple goals and objectives were not met,
or were not met within a reasonable or agreed timeframe.
Unsatisfactory (1):
Performance did not meet expectations or satisfy job requirements, and major
improvement is needed in most areas. Majority of goals and objectives were not met,
or were not met within a reasonable or agreed timeframe.
Not Applicable (0):
This item does not apply (i.e. associate is a mid-year hire and cannot be accurately
assessed).
Part C – Signatures: Signatures will be required during the Planning and Check-In stages. Sign the form and submit to your manager. Once your
manager has signed the review, keep a copy of the form for your record. You will acknowledge the review at year-end electronically via the HR
portal.
Part D – Competencies: Competencies are the knowledge, skills, and abilities required to perform a job. Choose the applicable rating for each
competency using the above scale and provide comments as appropriate at year-end.
Part E – Strengths & Opportunities and General Comments:
Strengths and Opportunities: At year-end, take a moment to highlight areas where you felt you excelled, and those that need to be improved
upon or focused on for the upcoming review period.
General Comments: If desired, you can provide additional remarks on your performance in this section.
Part F – Overall Rating: Select the applicable overall rating for yourself based on your performance with regards to strategic and developmental
goals as well as competencies.
Submit the completed self-assessment and draft goals to your manager by February 15, 2015.

2. Goal 1
End of Year: Assessment
Comments: Jon processed 5 pallets of recycleable material including breaking down PCs, removing drives, and documenting them. Jon has
done a really good job salvaging PCs and Laptops by reusing parts so that they can still be used and put back into produc tion.
Not Applicable (0) Unsatisfactory (1) Improvement Needed (2) Meets Expectations (3)
Exceeds Expectations
(4)
Exceptional (5)
Goal 2
End of Year: Assessment
Comments: Jon had to develop a method in which to derive usable metrics from the Helpdesk system
Not Applicable (0) Unsatisfactory (1) Improvement Needed (2) Meets Expectations (3)
Exceeds Expectations
(4)
Exceptional (5)
Review Period:1/1/2014
to 12/31/2014
Associate’s Name: Jonathan
Fuller
Position Title: Helpdesk
Technician
Manager’s Name: Christopher Simmons
Beginning of Year: Planning Mid-Year: Check-In
Strategic Goal Measure of Success Comments Explain Any Change Measure of Success Comments
lTo process old IT
equiment and ensure
no corporate data
contained within
equipment
Old equipment will be
documented in
helpdesk system
Hard disk erasures
will be recorded in
helpdesk system
Document from
recycler will be
obtained
No Change
Beginning of Year: Planning Mid-Year: Check-In
Strategic Goal Measure of Success Comments Explain Any Change Measure of Success Comments
lTo develop helpdesk
trends and suggest
actions to be taken to
address any trends
found
This goal will be
measure by reports
and trends
discovered as well as
any action taken
No Change

3. Goal 3
End of Year: Assessment
Comments: Jon completed this goal
Not Applicable (0) Unsatisfactory (1) Improvement Needed (2) Meets Expectations (3)
Exceeds Expectations
(4)
Exceptional (5)
Developmental Goal
End of Year: Assessment
Comments: Complete. Attended 4 cross train classes.
Beginning of Year: Planning Mid-Year: Check-In
Strategic Goal Measure of Success Comments Explain Any Change Measure of Success Comments
lTo perform
Corporate Software
and Hardware audit
to ensure software
compliance and have
a detailed snapshot
of corporate systems
to predict future
purchasing
This goal will be
measured by reports
developed from data
No Change
Beginning of Year: Planning Mid-Year: Check-In
Strategic Goal Measure of Success Comments Explain Any Change Measure of Success Comments
lTo expand
knowledge of
corporate systems by
attending cross
training classes
Attend cross training
classes
No Change

4. Not Applicable (0) Unsatisfactory (1) Improvement Needed (2) Meets Expectations (3)
Exceeds Expectations
(4)
Exceptional (5)
Part C: Signatures:
*Competencies are located on the next page*
*Please complete as a part of your self-assessment at year-end*
Beginning of Year: Signatures
I acknowledge that I have reviewed my goals and discussed them with my manager.
Associate: Date:
Manager: Date:
Mid-Year: Signatures
I acknowledge that I have reviewed my updated goals and discussed them with my manager.
Associate: Date:
Manager: Date:

5. Part D: Competencies
Customer Focus -
Internal/External:
 Values the importance of delivering timely, high quality, innovative service to
internal and external clients.
 Works with customers to assess their needs, provide information or
assistance, resolve their problems, or satisfy their expectations.
 Is committed to providing quality products and services.
 Skillfully serves diverse customer base.
 Asks customers for feedback, and applies responses as necessary.
 Strives to improve the quality of service and products.
 Displays a can do, will do attitude.
Not Applicable
(0)
Unsatisfactory
(1)
Improvement
Needed (2)
Meets
Expectations (3)
Exceeds
Expectations (4)
Exceptional
(5)
Comments: Jon has taken over as the lead helpdesk position. He takes the lions-share of the infrastructure tickets
and has done a very good job managing multiple priorities and deadlines. Jon images and distributes all the new PCs
and laptops and has instuted a method of follow up with users after receiving new systems to follow up and train
them. Jon has gone above and beyond the call of duty to troubleshoot systems issues by thoroughly researching
issues and potential fixes.
Quality/Continuous
Improvement:
 Strives to eliminate errors and seeks opportunities to improve product /
services.
 Demonstrates efficiency and quality in one’s own work.
 Understands the value of innovation and continuous improvement.
 Improves processes and practices by identifying inefficiencies and
redundancies, driving continuous improvement.
 Collaborates with partners to improve the quality of products and service.
Not Applicable
(0)
Unsatisfactory
(1)
Improvement
Needed (2)
Meets
Expectations (3)
Exceeds
Expectations (4)
Exceptional
(5)
Comments: Jon collaborates very well with the rest of the team. Jon strives to understand corporate systems and
their common issues and, if possible, improve upon them.

6. Safety:
 Follows safety procedures and works in a safe manner, setting the example
for others.
 Identifies safety issues and problems by detecting hazardous working
conditions and correcting them, upholding safety standards.
 Makes recommendations and/or improves safety and security procedures.
 Watches out for the safety of others.
Not Applicable
(0)
Unsatisfactory
(1)
Improvement
Needed (2)
Meets
Expectations (3)
Exceeds
Expectations (4)
Exceptional
(5)
Comments: Jon follows all safety guidelines as outlined by Human Resources and Safety
Part E: Strengths & Opportunities and General Comments
Strengths & Opportunities
Jon can handle multiple issues and follow them all through to completion. Jon also has a great thirst for knowledge
and puts forth great effort to understand and solve issues on his own, but he also will reach out for help when
warranted. ERP rollout, new HQ, consolidations, and possible acquisitions will provide many opportunities to
contribute in 2015 as well as improving technologies that can be applied to corporate systems
General Comments
Jon has been a tremendous asset to the HQ IT. He has put through great effort to learn corporate technologies and
become proficient on his own.
Part F: Overall Rating – Select the applicable overall rating for the associate based on their performance
on the competencies.
Overall Rating
Not Applicable
(0)
Unsatisfactory
(1)
Improvement
Needed (2)
Meets
Expectations (3)
Exceeds
Expectations (4)
Exceptional
(5)