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State of West Virginia
EMPLOYEE PERFORMANCE APPRAISAL
Employee’s Name (last, first, middle)
Social Security Number
Position Title
Time in Present Position (in months)
Department
Type of Rating
Division
Annual
Probationary
Special
Section
❍
❍
❍
Rating Period
Supervisor’s Name
Supervisor’s Title
RESPONSIBILITIES: Essential duties and responsibilities as identified in the functional job description.
PERFORMANCE STANDARDS and EXPECTATIONS: Objectives to be accomplished during this rating period.
ACKNOWLEDGEMENT: A discussion of duties, responsibilities, performance standards, and expectations for
the current period took place on the date below. We acknowledge our understanding of these duties, re-
sponsibilities, standards, and expectations, and how they will be used to measure work-related perfor-
mance during this period.
Supervisor’s Signature
Employee’s Signature
Date
Date
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State of West Virginia
EMPLOYEE PERFORMANCE APPRAISAL
RATING INSTRUCTIONS
Preparation
• Schedule an interview with each employee.
• Provide each employee with a copy of this form for self-evaluation.
Note: Self evaluation should be encouraged but not required.
• Complete this form prior to interview, commenting briefly on all performance elements.
Those elements checked “Needs Improvement” or “Exceeds Expectations” require
comment.
Note: Comments, negative or positive, should come as no surprise to the employee.
• Review the completed form with your manager prior to the employee interview.
Interview
• Meet with employee privately and without interruption.
• Review employee’s functional job description together with expectations and standards
established and communicated at beginning of performance period.
• Discuss completed appraisal form(s), allowing for employee input.
• Encourage employee to make written comments on completed form.
• Sign the form in employee’s presence and secure his/her signature.
Completing the Form
• With the Rating Category Key as your guide, check the appropriate box for each element.
Remember that these