Alaska Performance Evaluation Report
ADVERTISEMENT
1
2STATE OF ALASKA
PERFORMANCE EVALUATION REPORT
NAME
SOCIAL SECURITY NO.
DEPARTMENT
DIVISION
Administration
REASON FOR REPORT
PCN
JOB CLASSIFICATION TITLE
REPORT COVERAGE
[ ] ANNUAL
[ ]
RESIGNATION
[ ]
COMPLETION OF PROBATION
FROM
TO
[ ] OTHER (SPECIFY)
POSITION DESCRIPTION REVIEWED BY RATER
NARRATIVE SECTION
YES
NO
If no, explain:__________________________
U
Acceptable
O
[ ]
[ ] [ ] [ ]
[ ]
Overall Effectiveness on the Job
SPECIFIC RATING AREAS
(Overall Effectiveness MUST be explained. Other performance consideration, such as strong points and areas needing improvement, should be
included.)
* U
A
O
[ ] [ ] [ ]
PERFORMANCE
(As shown by: quantity, quality, accuracy, and completeness of work;
knowledge of job fundamentals; judgement shown on the job;
willingness and ability to carry out new assignments; independence of
performance; attitude towards job.)
[ ] [ ] [ ]
WORK HABITS
(As shown by:
attendance; punctuality, appearance and grooming;
safety.)
[ ] [ ] [x]
INTERPERSONAL RELATIONSHIPS
Rater's Recommended Action:
(As shown by: consideration of public and co-workers; acceptance of
(See Instructions over)
supervision.)
Rating was discussed with employee
[ ]Yes [ ] No If no, explain:_________________
[ ] [ ] [ ]
SUPERVISORY
(For Supervisory
Employees Only)
Signature of Rater___________________________________________Title___________________________________Date__________________________
!
!
Employee:
Concur with Rating
Disagree (Employee comments on Back)
(As shown by:
training and directing subordinates; evaluating
subordinates; planning and organizing work, including delegation;
Signature: __
Date _
problem solving and decision-making ability; affirmative action
REVIEWED AND APPROVED BY:
achievement; cost effectiveness; and Labor Contract Administration.)
Division
Signature: _
Title _
Date _
* U =
Unacceptable
A = Acceptable
Department
O =
Outstanding
Signature: _
Title _
Date _
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Legal