INDIVIDUAL PERFORMANCE AND CONTRIBUTION DISCUSSION FORM (FOR NON-SUPERVISORS) EMPLOYEE NUMBER [ENPLOYEE NAME, RATING PERIOD From JOB TME to TWMEDIATE SUPERIORS NAWE DEPARTMENT CATEGORY 112] 3 | 4 fs] 67] 8] 9 | 17 PERFORMANCE LEVEL ‘have participated in this dgcussion wih my manager supervisor and have reviewed my records. [Employes Signature Date | have participated in this discussion with my manager / supervisor and have reviewed my record. [ManageriSuperisors Signatures Date "have participated in this ciscussion with my manager / supervisor and have reviewed my records. [Nextievel Manager Signature (ifthe overall performance and contributing reting is 3.6 or above) DatePERFORMANCE AND CONTRIBUTION CATEGORIES PERFORMANCE AND PERFORMANCE AND 4 3 2 1 ° CONTRIBUTION RATING 4 3 2 1 ° CONTRIBUTION RATING 41. Quality of work: How effectively this person produces ahigh |} 2. Quantity of Work: The extent to which this person produces a caliber of work compared wih accepted standards of parfermance witin |} specifed amount or volume of work compared to department standards the department concerning appropriate level of deta, accuracy, || schedules, commitments, and deadlines, and actively seks new work oF completeness, thoroughness, scape, formal, and amount of correction or | offers tonelp others when not busy with current projects / assignments, revision required. ‘COMMENTS / DOCUMENTATION ‘COMMENTS / DOCUMENTATION perrormance and || , [| | 2], | , | Perrormanceano |, ],]./,/, CONTRIBUTION RATING CONTRIBUTION RATING 3, Behavior Flexibility: How effectively this person advantage to || 4. Working with Minimal Supervision: How efectvely this person flows through on assignment, reques the appropriate lavel of ‘changing work demands and priors, leams and assumes new tasks, and contles emoton under the demands of ime, muitple assignments or ||" superision, and recognizes the reeds for action and assumes resistant rom others (e.g, customers). responsibilty wthout prompting ‘COMMENTS / DOCUMENTATION ‘COMMENTS / DOCUMENTATIONPERFORMANCE AND CONTRIBUTION CATEGORIES PERFORMANCE AND CONTRIBUTION RATING || * || > | 2] 7 | ° PERFORMANCE AND CONTRIBUTION RATING || * | > | ? 1 1 || ° 5. Cooperation and Teamwork: How effectively this person ‘gets along and communicates wih person within between eparimenis and aids the progress or workgroups or team projects, 6. Planning, Organizing: How effecvely ths person recognizes. ‘and sets priors, pots @ smoath flow of work to achieve results inthe easiest possible fashion, organizes the work tobe performed, and in general avois "ess" types of situation, ‘COMMENTS / DOCUMENTATION (COMMENTS / DOCUMENTATION PERFORMANCE AND CONTRIBUTION RATING PERFORMANCE AND CONTRIBUTION RATING 7. Working Safety: The extent which this person follows safety procedures, s watchful for safety hazards, take action to correct oF prevent hazards, and communicates wih others about safety hazards 8. Attendance: The extent which this person isin attendance compared to departmental standards or expectations. (COMMENTS / DOCUMENTATION (COMMENTS / DOCUMENTATIONPERFORMANCE AND CONTRIBUTION CATEGORIES PERFORMANCE AND CONTRIBUTION RATING PERFORMANCE AND 413] 2] 4 | ° | contrisution ratine alis]2qato 9, Punctuality: The extent which ths person is punctual compared ee ee 10. Optional Category: (Piease define in deta) ‘COMMENTS / DOCUMENTATION (COMMENTS / DOCUMENTATIONPERFORMANCE PLANNER In this section, you are to work with your staff member on a developmental plan to improve areas of performance concern and / or to acquire knowledge, skills, or abilities for future growth opportunittes. Performance Areas Where Knowledge, Skils,OrAbiities That || Developmental Improvements Needed or Future || Must Be Developed To Result in The ‘Actes Implementation Date |} Completion Date (Growth Opportunities Improvement of Future Growth ‘Assignments (Month Year) |! (Montn Year)