Self appraisal sample

Sample Employee Self-Appraisal Form

Employee: ________________
Date: ____________________
Company: ________________
Position Title: _____________
Review Period: ____________
Office: ___________________
Department: ______________
From/To: _________________

I. Job descriptions and responsibilities: __________________________________
________________________________________________________________
________________________________________________________________

II. Specify ways that you feel you met or exceeded job requirements and any reasons why.
1. ______________________________________________________________
______________________________________________________________
2. ______________________________________________________________
______________________________________________________________
3. ______________________________________________________________
______________________________________________________________
III. Specify the ways that you feel you did not meet job requirements and any reasons why.
1. ______________________________________________________________
______________________________________________________________
2. ______________________________________________________________
______________________________________________________________
3. ______________________________________________________________
______________________________________________________________
IV. In what specific areas would you like to improve your job performance?
1. ______________________________________________________________
______________________________________________________________
2. ______________________________________________________________
______________________________________________________________
3. ______________________________________________________________
______________________________________________________________

V. List the steps you would like to take to improve your preparation for future
opportunities.

1. ______________________________________________________________
______________________________________________________________
2. ______________________________________________________________
______________________________________________________________
3. ______________________________________________________________
______________________________________________________________
VI. What job-related goals would you like to accomplish in the next 6 (12) months?
1. ______________________________________________________________
______________________________________________________________
2. ______________________________________________________________
______________________________________________________________
3. ______________________________________________________________
______________________________________________________________
VII. List additional items you would like to discuss.
1. ______________________________________________________________
______________________________________________________________
2. ______________________________________________________________
______________________________________________________________
3. ______________________________________________________________
______________________________________________________________
Employee’s Signature: ____________________Date: ______________________
Reviewer’s Signature: ____________________Date: ______________________
Reviewer’s Manager’s Signature: ____________Date: ______________________

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