Downloadable Form 3.

1 - Model Annual Performance Appraisal Form*

Name: ________________________________________________

Date__________________

Part I: Review of Progress toward Meeting Last Years Objectives

Objectives/Projects

Results

Weighting

(As modified during the year)

(Narrative)

(Must total 100%)

1.

Rating

Greatly exceeded expectation

Consistently exceeded expectation
Fully met expectation
Did not meet expectation
Significantly below expectation

Greatly exceeded expectation

Consistently exceeded expectation
Fully met expectation
Did not meet expectation
Significantly below expectation

Greatly exceeded expectation

Consistently exceeded expectation
Fully met expectation
Did not meet expectation
Significantly below expectation

Greatly exceeded expectation

Consistently exceeded expectation
Fully met expectation
Did not meet expectation
Significantly below expectation

Greatly exceeded expectation

Consistently exceeded expectation
Fully met expectation
Did not meet expectation
Significantly below expectation

2.

3.

4.

5.

Overall Weighted Average Rating for Objectives

*Copyright 2006 by Swan Consultants, Inc. To customize this document, download to your hard drive from www.wiley.com/go/PerformanceAppraisalForms.
The document can then be opened, edited, and printed for personal use only, using Microsoft Word or another popular word processing application.

Part II: Review of Progress toward Meeting Expectations of Performance Agreed to Last
Year
Perfomance Factors

Weighting

(Examples)

(Must total 100%)

1. Customer Service

Greatly exceeded expectation

Consistently exceeded expectation
Fully met expectation
Did not meet expectation
Significantly below expectation

Greatly exceeded expectation

Consistently exceeded expectation
Fully met expectation
Did not meet expectation
Significantly below expectation

Greatly exceeded expectation

Consistently exceeded expectation
Fully met expectation
Did not meet expectation
Significantly below expectation

Greatly exceeded expectation

Consistently exceeded expectation
Fully met expectation
Did not meet expectation
Significantly below expectation

Greatly exceeded expectation

Consistently exceeded expectation
Fully met expectation
Did not meet expectation
Significantly below expectation

2. Quality of Work

3. Quantity of Work

4. Teamwork/Cooperation

5. Initiative/Motivation

6. Communication Skills

Perfomance Factors
(Examples)

7. Technical Skills/Comman of Knowledge

Rating

Greatly exceeded expectation

Consistently exceeded expectation
Fully met expectation
Did not meet expectation
Significantly below expectation
Weighting
Rating
(Must total 100%)

Greatly exceeded expectation

8. Management/Leadership

Consistently exceeded expectation

Fully met expectation
Did not meet expectation
Significantly below expectation

Greatly exceeded expectation

Consistently exceeded expectation
Fully met expectation
Did not meet expectation
Significantly below expectation

Greatly exceeded expectation

Consistently exceeded expectation
Fully met expectation
Did not meet expectation
Significantly below expectation

9. Efficient Internal Operations

Overall Weighted Average Rating for Objectives

Part III: Summary of Overall Performance for Year
Weighted Average of Objectives and Performance Factors
Greatly exceeded expectation of performance
Consistently exceeded expectation
Fully met expectation
Did not meet expectation
Significantly below expectation of performance

Narrative summary:
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
Part IV: Development Plan
A. For use if any individual rating is below "fully met expectation," or if employee wants to work
on an area of current job.
For improvement in current job, the following actions/objectives have been agreed to:

1.

________________________________________________________________________

2.

________________________________________________________________________

3.

________________________________________________________________________

B. For use if advancement or career growth is a practical option and employee is interested.
For preparation for possible advancement, the following actions/objectives have been agreed to:
1.

________________________________________________________________________

2.

________________________________________________________________________

3.

________________________________________________________________________

C. Job enrichment: For use if advancement or career growth is not an option, or if employee is not
interested.
The following actions/objectives have been agreed to:
1.

________________________________________________________________________

2.

________________________________________________________________________

3.

________________________________________________________________________

Part V: Perfomance Plan

These are the objectives or projects that employee and manager agree on for the next year (additions or
modifications are to be done in writing). These objectives become the subject matter of Part I of the form
for next year.
1. ____________________________________________________________________________
2. ____________________________________________________________________________
3. ____________________________________________________________________________
4. ____________________________________________________________________________
5. ____________________________________________________________________________
6. ____________________________________________________________________________

Part VI: Employee Statement

(OptionalAdditional sheets may be used)
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________

Part VII: Signatures

Manager (Direct Supervisor)

Employee

Date
Date

(Signature acknowledges that this form has been

reviewed with employee. It does not imply agreement with content).
Initials
Prior to
Appraisal
Discussion (

Initials
Prior to
Appraisal
Discussion (

Department Manager
Human Resources

Date
Date

___________