Republic of the Philippines

Department of Education
REGION XI
SCHOOLS DIVISION OF TAGUM CITY

Job-Order Employee Performance and Feedback Form

Dear Respondent:

All information asked in this questionnaire are CONFIDENTIAL. It shall NOT be disclosed/ revealed to
another. Do not discuss the questions asked with anyone else. You shall be held liable for any disclosure of
information from this.
Feel free to answer the items to the best of your knowledge without fear. Writing your full name is
OPTIONAL, however, signature at the bottom of the last page is requested. You may answer in English, Filipino,
Visayan or mixed.

NAME: ___________________________________ POSITION/OFFICE: _________________

PART I. Rate according to the following items from 1 – 5, with 5 as the highest and 1 the lowest. Check
(/) the column corresponding your rating.
NUMERICAL RATING / ADJECTIVAL RATING:
5- OUTSTANDING 4- VERY SATISFACTORY 3 – SATISFACTORY
2- UNSATISFACTORY 1 - POOR

A. GENERAL QUALITIES 5 4 3 2 1
1. Work Ethics
2. Attitude towards colleagues/co-workers
3. Leadership Qualities
4. Positive Influence to others
5. Worthiness to the position
B. HUMAN RELATIONS
1. Adjusts to the variety of personalities, ranks and
informal groups (Nakikibagay sa iba’t-ibang uri ng personalidad, posisyon at
grupo)
2. Internalizes work changes with ease & vigor
(Masinsinang tinatanggap ang trabaho na iniatas sa kanya)
3. Accepts constructive criticisms objectively whether from subordinates,
peers or superiors
(Bukal sa kalooban na tinatanggap ang mga puna mula sa kasamahan, mga
nasa mas mababang posisyon at mga nasa mataas na posiyon)
4. Observes proper decorum in relating with superiors and peers
(May respeto at nagpapakita ng mainam na ugali sa mga kasamahan sa
trabaho, mababa man o mataas na posisyon)
5.Takes initiative to organize work groups, adopt procedures and standards in
his own level
(May sariling diskarte sa mga gawain na kanyang saklaw )
C. DESICIVENESS
1. Thinks logically and acts accordingly
(May sariling desisyon at isinasagawa nya ito)
2. Considers alternatives & recommends solutions when faced with problem
situations
(Kung may problema, hinaharap ito at nag-iisip ng posibleng paraan at
solusyon)
3. Gives convincing recommendations & suggestions
(Nagbibigay ng mga mabuting ideya at mungkahi)

4. Acts quickly and makes best decision possible

(Mabilis kung kumilos at nakakapagbigay ng mainam na desisyon)

Address: Energy Park, Apokon, Tagum City, 8100

Telephone No.: (084) 216-3504
Email: tagum.city@deped.gov.ph
Website: deped.tagumcity.gov.ph
 Republic of the Philippines
Department of Education
REGION XI
SCHOOLS DIVISION OF TAGUM CITY

5. Exercises flexibility
(Marunong makibagay sa kahit anong sitwasyon)

D. STRESS TOLERANCE 5 4 3 2 1
1. Exercises high degree of tolerance for tension resulting from increasing
volume of work, organizational change, environmental conflicts, etc. (May
mataas na antas ng pasensya kahit sa gitna ng maraming trabaho, presyur
at mga kaguluhan sa opisina/ eskwela)
2. Uses coping mechanisms to handle creatively the tensions resulting from
one’s work. (Katanggap-tanggap ang ugali kahit mabigat at marami ang
trabaho/problema)
3. Controls negative manifestations of emotions
(May kontrol sa sarili sa gitna ng iba’t-ibang emosyon)
4. Performs duties & functions satisfactorily in a tension-laden situation.
(Hindi apektado ang pag-trabaho kahit na may tensyon sa opisina/eskwela)
5. Channels negative emotions to positive and constructive endeavour. (May
kontrol sa sarili sa gitna ng hindi kanais-nais na sitwasyon)
GRAND TOTAL

PART II. Please share your ideas about the Job-Order Employee based on the following questions:

1. Any idea on the work ethics/ work attitude of the said personnel. Does he/she did well? Is he/she a
committed worker? Explain.
______________________________________________________________________________________
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2. Does she have a harmonious relationship with his/her colleages? Give details.
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3. Is he/she worthy to be hired as job order in our division? Please explain.

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REMARKS:
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SIGNATURE: ___________________________ DEPED TAGUM BACKGROUND INVESTIGATION FORM

NAME (OPTIONAL): _____________________ Revised 2018

Address: Energy Park, Apokon, Tagum City, 8100

Telephone No.: (084) 216-3504
Email: tagum.city@deped.gov.ph
Website: deped.tagumcity.gov.ph