PERFORMANCE MANAGEMENT PROCESS (PMP) EXEMPT EMPLOYEE FORM (OPTIONAL SHORT FORM) Rating Period Covered: Employee’s Name: Employee’s Job Title: Department: Division: Supervisor’s Name: Supervisor’s Job Title: Performance Factors Satisfactory Unsatisfactory NOTE: Check the box that best describes the performance of this employee on Exceptional/Highly Improvement Required/ each of the following factors: Effective/Effective Unsatisfactory 1. Job Knowledge 2. Quality of Work 3. Quantity of Work 4. Dependability 5. Communication Skills 6. Interacting with Others 7. Customer Service Skills Supervisory Performance (Rate only if employee supervises others) A. Planning/Setting Objectives B. Organization and Work Allocation - Coordination C. Staffing D. Leadership/Motivation E. Performance Review/Development Process Comments: (Identify of outstanding performance/accomplishments; goals; and indicate plan for addressing areas needing improvement.) Summary of Overall Performance Exceptional Highly Effective Effective Improvement Required Unsatisfactory Please check one: The employee and supervisor are in agreement not in agreement with the performance appraisal results. If the employee does not agree, the employee may submit his/her concerns in writing. Employee’s Signature: Date: Expectation Setting Meeting Held Supervisor’s Signature: Date: Employee’s Signature: Date: Mid-way Feedback Session Held Supervisor’s Signature: Date: Employee’s Signature: Date: Final Appraisal Meeting Held Supervisor’s Signature: Date: NOTE: The employee’s signature does not necessarily indicate agreement with the performance appraisal results. The signature indicates only that the performance appraisal was held. Reviewed by next higher level supervisor or department designee Reviewer’s Signature: Date:
PERFORMANCE MANAGEMENT PROCESS (PMP) EXEMPT EMPLOYEE FORM (OPTIONAL SHORT FORM) Rating Period Covered: Employee’s Name: Employee’s Job Title: Department: Division: Supervisor’s Name: Supervisor’s Job Title: Performance Factors NOTE: Check the box that best describes the performance of this employee on each of the following factors: Satisfactory Unsatisfactory Exceptional/Highly Effective/Effective Improvement Required/ Unsatisfactory 1. Job Knowledge 2. Quality of Work 3. Quantity of Work 4. Dependability 5. Communication Skills 6. Interacting with Others 7. Customer Service Skills Supervisory Performance (Rate only if employee supervises others) A. Planning/Setting Objectives B. Organization and Work Allocation - Coordination C. Staffing D. Leadership/Motivation E. Performance Review/Development Process Comments: (Identify of outstanding performance/accomplishments; goals; and indicate plan for addressing areas needing improvement.) Summary of Overall Performance Exceptional Highly Effective Effective Improvement Required Unsatisfactory Please check one: The employee and supervisor are in agreement not in agreement with the performance appraisal results. If the employee does not agree, the employee may submit his/her concerns in writing. Expectation Setting Meeting Held Employee’s Signature: Date: Supervisor’s Signature: Date: Mid-way Feedback Session Held Employee’s Signature: Date: Supervisor’s Signature: Date: Final Appraisal Meeting Held Employee’s Signature: Date: Supervisor’s Signature: Date: NOTE: The employee’s signature does not necessarily indicate agreement with the performance appraisal results. The signature indicates only that the performance appraisal was held. Reviewed by next higher level supervisor or department designee Reviewer’s Signature: Date:
ShortPMPForm_revJune2015.docx