The document is a performance appraisal form for an employee that assesses their performance in several key areas over the review period. It evaluates the employee's performance in maintaining confidentiality and adhering to safety and compliance policies (10% each), interpersonal skills and teamwork (20%), and job/technical skills and knowledge of course material (20%). The supervisor and employee provide ratings and comments for each area to analyze results, improvement, and whether expectations were met. The purpose is to develop communication, assess performance, and promote employee development.

1. 1
Performance
Appraisal
The
purpose
of
conducting
the
Performance
Appraisal
is
to
develop
better
communication
between
employee
and
supervisor,
assess
performance,
improve
quality
of
work,
increase
productivity,
and
promote
employee
development.
Your
Performance
Appraisal
is
comprised
of
key
factors
which,
when
considered
together,
determine
your
performance
for
the
review
period.
These
factors
include:
• Your
performance,
and
the
results
you
attained
in
carrying
out
your
day-­‐to-­‐day
responsibilities
• Your
performance,
and
the
results
you
attained
in
carrying
out
your
strategic
objectives
• The
progress
you
made
against
your
development
objective(s)
• The
values
and
behaviours
you
demonstrated
while
conducting
your
day-­‐to-­‐day
work
and
completing
your
strategic
objectives
EMPLOYEE
Name:
Job
Title:
Employee
ID:
Date:
SUPERVISOR
Name:
Job
Title:
Employee
ID:
Date:
Review
Date:
Date
of
Next
Review:
Exceptional
Employee
consistently
exceeds
all
the
expectations,
objectives,
and
responsibilities
for
the
job.
Employee
demonstrates
superior
knowledge
and
ability
to
take
initiative.
Employee
regularly
makes
suggestions
to
improve
processes
resulting
in
a
positive
impact
on
the
organization.
Advanced
Employee
achieves
and
frequently
exceeds
expectations,
objectives,
and
responsibilities
for
the
job.
Employee
is
sought
out
to
make
suggestions
on
how
to
improve
processes
for
the
organization.
Competent
Employee
displays
good
level
of
knowledge
and
competence.
Employee
meets
expectations,
objectives,
and
responsibilities
for
the
job.
Satisfactory
Employee
displays
acceptable
level
of
knowledge
and
competence.
Employee
often
meets
expectations,
objectives,
and
responsibilities
for
the
job.
Improvement
needed
Employee
does
not
consistently
meet
expectations,
objectives,
and
responsibilities
for
the
job.
Employee
displays
some
knowledge
and
abilities
to
do
the
job
at
a
satisfactory
level.
Major
Improvement
Needed
Employee
rarely,
if
ever,
displays
knowledge
and
abilities
to
do
the
job
properly.
Employee
rarely
meets
expectations,
objectives,
and
responsibilities
for
the
job.
Requirements
for
the
position
have
not
been
met.

2. 2
SECTION
1:
This
section
will
describe
the
accountabilities
and
expectations
of
the
employee
of
each
category
listed.
Summary
comments
should
reflect
the
results
achieved
in
carrying
out
ongoing
day-­‐to-­‐day
responsibilities
and
strategic
objectives,
progress
made
against
the
development
objective,
as
well
as
the
manner
in
which
our
corporate
values
and
behaviours
were
demonstrated.
Confidentiality
and
Security:
The
employee
is
responsible
to
maintain
the
academic
code
of
conduct.
They
would
keep
all
proprietary
information
of
the
students
confidential
and
secure.
Weight:
10%
Supervisor
rating:
6
5
4
3
2
1
Employee
Rating:
6
5
4
3
2
1
Supervisor
comments-­‐
______________________________________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________________________________
Safety
and
Compliance
with
Company
Policies:
The
employee
maintains
a
safe
and
clean
environment
in
the
workplace.
Adheres
to
company
policies
and
guidelines
at
all
times.
Weight:
10%
Supervisor
rating:
6
5
4
3
2
1
Employee
Rating:
6
5
4
3
2
1
Supervisor
comments-­‐
_____________________________________________________________________________________________________________________________________________
_____________________________________________________________________________________________________________________________________________
_____________________________________________________________________________________________________________________________________________
_____________________________________________________________________________________________________________________________________________
Interpersonal
Skills
and
Teamwork:
Able
to
develop
and
maintain
effective
relationships
internally
and
externally.
Able
to
work
well
with
and
be
flexible
with
students,
co-­‐workers
and
subordinates
to
maintain
a
fair
and
positive
environment.
Treats
all
students,
co-­‐workers
and
subordinates
with
dignity
and
respect.
Weight:
20%
Supervisor
rating:
6
5
4
3
2
1
Employee
Rating:
6
5
4
3
2
1
Supervisor
comments-­‐
______________________________________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________________________________

3. 3
Job/Technical
Skills
and
Knowledge:
The
employee
possesses
and
demonstrates
knowledge
of
course
material.
The
employee
remains
current
in
effective
teaching
methods
and
applies
them
to
their
job.
Weight:
20%
Supervisor
rating:
6
5
4
3
2
1
Employee
Rating:
6
5
4
3
2
1
Supervisor
comments-­‐
______________________________________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________________________________
Problem
Solving
and
Decision
Making:
The
employee
is
able
to
apply
effective
problem
solving
abilities
in
their
work
to
resolve
conflicts.
They
are
able
to
make
sound
and
professional
decisions
that
create
minimal
negative
effect.
They
willingly
take
ownership
for
decisions
made.
Weight:
10%
Supervisor
rating:
6
5
4
3
2
1
Employee
Rating:
6
5
4
3
2
1
Supervisor
comments-­‐
______________________________________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________________________________
Planning
and
Organizations:
Able
plan
effectively
and
maintain
organization
when
completing
work.
The
employee
is
able
to
complete
work
well
before
required
deadline.
Able
to
prioritize
all
tasks
and
duties
effectively.
Weight:
10%
Supervisor
rating:
6
5
4
3
2
1
Employee
Rating:
6
5
4
3
2
1
Supervisor
comments-­‐
______________________________________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________________________________
Communication
(Verbal
and
Written):
Able
to
effectively
communicate
and
transfer
knowledge
of
course
material.
Engages
students
to
learn
and
understand
course
material
to
encourage
student
success.
Able
to
speak,
listen
and
write
effectively
in
individual
and
group
settings.
Provides
accurate
and
concrete
feedback
to
students.
Weight:
20%
Supervisor
rating:
6
5
4
3
2
1
Employee
Rating:
6
5
4
3
2
1
Supervisor
comments-­‐
______________________________________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________________________________

4. 4
Overall
Rating:
Calculate
the
overall
score
based
on
the
weighted
rating
scale.
Supervisor’s
total
points:____________
Employee’s
total
points:____________
Major
achievements
and
contributions:
List
all
achievements
done
by
the
employee.
Supervisor
comments:
______________________________________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________________________________
Areas
of
development:
Based
on
the
employee’s
results,
describe
the
areas
of
development
for
the
next
semester.
Supervisor
comments:
______________________________________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________________________________
Employee
Comments:
Please
provide
comments
and
examples
of
behaviours
conducted
in
the
last
semester.
______________________________________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________________________________
Goal
(Describe
in
a
complete
sentence
the
outcome
and/or
result
you
are
trying
to
achieve
and
why
it
is
important.
Meaningful
objectives
are
SMART
(specific,
measurable,
achievable,
realistic,
time
bound)
Action
Plan
(What
steps
and/or
activities
will
help
you
achieve
the
objective?)
Performance
Measurements
and
Outcomes
(How
will
you
know
that
you
have
successfully
achieved
the
desired
outcome/result?)
Due
Dates
(Required
for
each
performance
measure/outcome
listed)
Goals:

5. 5
Supervisor
comments
on
results
achieved:
______________________________________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________________________________
Employee
comments
on
results
achieved:
______________________________________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________________________________
Second-­‐Level
Review
(OPTIONAL):
Employee
Final
Comments
(if
applicable,
based
on
the
results
of
a
2nd
level
review):
Employee:
IMPORTANT!
MUST
BE
COMPLETED
EVERY
YEAR:
Code
of
Conduct
–
Conflict
of
Interest
I
hereby
declare
that
I
have
read,
understand
and
will
adhere
to
the
Code
of
Conduct
and
Conflict
of
Interest
Policy.
I
understand
that
I
must
declare
any
actual
or
potential
conflict
of
interest.
Should
I
have
an
actual
or
potential
conflict
of
interest,
I
will
sign
and
submit
a
Declaration
of
Potential
Conflict
of
Interest
form.
______________________________________________
Date
______________________________________________
Supervisor
Signature
______________________________________________
Date
______________________________________________
Employee
Signature