Self-Appraisal Form: Personal Information
Self-Appraisal Form: Personal Information
Self-Appraisal Form: Personal Information
Review Period:
From To
Personal Information
Employee Name:
Position Title:
Department:
Employees should complete this form and give it to their supervisor. Employees should be prepared to
discuss this document as a part of the performance evaluation cycle. You should keep a copy of this
document for your records and make sure your supervisor has a copy for his/her records, as this will
not be forwarded to Human Resources for inclusion in your official personnel file.
This section should list your essential job responsibilities as they currently exist. Please group them into
five areas of responsibility as best you can. Also, indicate what you see as the level of importance on a
Form reviewed Oct 2021 Page 1 of 3
scale of 1-5 (with 1 being the highest) trying to use each number only once where possible.
Additionally, briefly describe the function of this responsibility (i.e., customer service, data integrity,
operation, quality, finance, etc.) that supports the level of importance assigned.
Level of Function
Job Responsibility
Importance (Support for Level of Importance)
Have any responsibilities been added or removed from your job duties during this review period?
If yes, what?
This section should list your most significant accomplishments or contributions as well as list any
particular strengths demonstrated during the review period.
Accomplishments: Briefly describe your accomplishments and achievements during the review period
and describe how these align with the goals and objectives outlined in your last performance
evaluation.
Strengths: Briefly describe the major strengths exhibited during this evaluation period and describe
how those strengths were demonstrated.
In this section, please share your thoughts and ideas on what your supervisor/manager could do during
the next review period to support you in doing your job. Please also share your ideas about the
additional support, if any, needed from your department, division or co-employees that would assist
you in doing your job more effectively.
Use this section to indicate your long-term career goals, if any, including any education, training, or
other professional development that you would like to begin or continue pursuing during the next
review period, especially as it relates to the department and/or Group mission.
In the space below, provide feedback regarding the knowledge, skills and abilities that you would like
to develop during the next review period. Please indicate, where possible, how this connects to the
department and/or company mission. Also, list the steps you intend to take to support your
development and/or improvement.