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Employee Self Evaluation Form
Name: Department:
Title: Date:
Instructions for Completing this Form
• Complete this form prior to the annual performance review with your supervisor.
• Make a copy of the completed Self Evaluation Form for your supervisor in advance of the
review meeting.
• The goal of this form is to provide information from which you and your supervisor, working
together, can create goals and action plans.
• Select a rating for each of the core competencies using the rating guide below.
Rating Guide -
The rating scale below is to be used to evaluate performance in each of the
competency areas.
Exceeds Standard:
Performance is repeatedly above expectation.
Meets Standard: Performance meets expectation.
Needs Improvement: Performance is sometimes below expectation.
Employee Self Evaluation Form
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