Name:____________________________________ Date:__________________________________
CORE COMPETENCIES
Integrity and Trust Meets ____% Doesn’t Meet ____%
Mission Integration Meets ____% Doesn’t Meet ____%
Team Relations Meets ____% Doesn’t Meet ____%
JOB SPECIFIC COMPETENCIES
Exceeds _____ Meets ____ Doesn’t Meet ____
Job Description
Exceeds _____ Meets _____ Doesn’t Meet ____
PROFESSIONAL GOALS:
To qualify for a merit increase, meets or exceeds must be marked in ALL areas above. IF all areas are marked MEETS or EXCEEDS, please sign and date below.
If Doesn’t Meet in any area, a work plan must be agreed upon at this time and copy attached to this document
Summary comments:
EVALUATION COMPLETED BY:
Supervisor: _____________________________ Date: ____________________________________
My signature indicates that I have received this performance review and that I have reviewed the job description and competencies. My signature indicates that I understand the expectations listed in both the job description and competencies.
Employee _______________________________Date:_____________________________________
Comments:
Signature of CEO:________________________Date:______________________________________