Self-assessment employee evaluation form checklist
This self-assessment employee evaluation form can be used by employees to reflect and evaluate their performance over-time. digital signatures were provided to validate discussion with the supervisor.
What does this form include?
This form contains 12 sections:
What were your most significant work-related accomplishments? (Include projects, assignments, new skills or knowledge gained.)
How do these accomplishments relate to your key responsibilities and goals for you and your unit/department?
What didn’t you accomplish that you had planned on accomplishing? Why?
What are your goals for the next evaluation period?
How will you accomplish these goals?
What do you need to accomplish these goals?
How can your supervisor help you to work more effectively and support your goals?
How can your team help you achieve your goals?
What additional training or development would help you improve and/or enhance your work performance?
What feedback or suggestions do you have to improve your unit and/or department?
Employee (Full Name and Signature)
Supervisor (Full Name and Signature)
Use this template