University of
Wisconsin-Madison,
Academic Staff Member: ____________________________________________________
Supervisor: _______________________________________________________________
The academic staff member completes each section
first. You can type as much as necessary to complete your answer within each
text box. The supervisor will have an opportunity to review each section and
comment. The employee and supervisor will meet to discuss the review.
1.
List your major accomplishments in the last year (or since you were
hired):
Employee
comments:
Supervisor
comments:
2.
Outline any of your duties that have changed since your last review.
Include duties that have been added, deleted, or significantly increased or
decreased.
Employee comments:
Supervisor comments:
3. Job-related
knowledge/skills: Do you have thorough and complete knowledge of your job
and/or the knowledge needed to perform your job? Do you possess effective
job-related skills and exercise those skills with independence and sound
judgment? Do you regularly assess/pursue learning new methods, technologies or
procedures to improve the accomplishment of job goals?
Employee comments:
Supervisor comments:
4. Productivity: The volume of
work regularly produced; speed and consistency. Do you exhibit innovation and
initiative?
Employee comments:
Supervisor comments:
5. Planning, organizing and
accomplishing goals: Are you focused, realistic, and systematic in your pursuit
of job objectives? Are you accurate, thorough? Are you in control of the
situation and able to triage priorities consistently?
Employee comments:
Supervisor comments:
Do you represent a work group and/or the
department effectively and in a positive manner? Are you cooperative, helpful
and independent?
Employee comments:
Supervisor comments:
7. Quality of work: Do you hold yourself to a
high standard of performance, consistent with the generally recognized
standards of your profession or area of specialization, and with the
expectations of your professional peers?
Employee
comments:
Supervisor
comments:
8. List
any outside professional activities and/or accomplishments that may be relevant
to this review:
Employee
comments:
Supervisor
comments:
9. Other:
Use this section to address any questions or concerns about your performance
expectations, supervisor, work environment, or any topics that the employee or
supervisor feel are significant and were not addressed elsewhere in these
performance criteria.
Employee
comments:
Supervisor
comments:
10. Set goals for the next year:
Employee
comments:
Supervisor
comments:
Signatures:
Supervisor_____________________________________________ Date_________
Employee______________________________________________ Date_________
(Employee signature
signifies only that this review has been discussed, not his/her agreement)
__________________________________________
Human Resources Manager,