Republic of the Philippines

Department of Education
REGION II – CAGAYAN VALLEY
SCHOOLS DIVISION OF QUIRINO
NAGTIPUNAN SOUTH DISTRICT
NAGTIPUNAN NATIONAL HIGH SCHOOL

Work Immersion Programme

STUDENT’S PERFORMANCE APPRAISAL FORM
STUDENT’S NAME: «NAME»
PARTNER INSTITUTION «chief»
SUPERVISOR:
PARTNER INSTITUTION: «PREFERRED_OFFICE»
PERIOD UNDER REVIEW: March 4-15, 2024

Rating Scale
1 - Unsatisfactory or Poor Performance-Performance does not meet the required standard.
Major improvements needed.
2 - Fair Performance-Performance partially meet the required standard. Less than
satisfactory could be doing better.
3 - Good or Average Performance – Performance has meet the required standard. Can
perform duties with minimal supervision.
4 - Very Good or Outstanding Performance – Performance exceeds the required standards.
For each behavioral items listed within the competency bands, please select the evaluation most suited
A. TEAM WORK TARGET RATING

1. Consistently work with others to accomplish goals and tasks 4

2. Treats all team members in a respectful courteous manner 4
3. Actively participates in activities and assigned task as required 4
4. Willingly works with team members to improve team 4
collaboration on a continuous basis
5. Consider the feedback and view of team members when 4
completing an assigned task
TOTAL 20

B. COMMUNICATION TARGET RATING

1. Actively listens to supervision and / or co worker 4

2. Comprehends written and oral information 4
3. Consistently delivers accurate information both written and 4
oral
4. Reliably provides feedback as required, both internal and 4
external
TOTAL 16

C. ATTENDANCE & PUNCTUALITY TARGET RATING

1. Is punctual on regular basis 4
2. Maintain a good attendance 4
3. Inform supervision in a timely manner when absenteeism 4
TOTAL 12

___________________________________________________________________________________________________________________________

Address: Purok 2 Ponggo, Nagtipunan, 3405, Quirino, Philippines

Contact Number: 09989726752
Email Address: 300662@deped.gov.ph
 D. PRODUCTIVITY TARGET RATING

1. Consistently delivers quality results 4

2. Has the ability to meet deadlines and manages time well 4
3. Has the ability to multi task 4
4. Has the ability to work around problems and obstacle in a 4
stressful situation in order to achieve the required task
5. Manages time effectively & efficiently 4
6. Efficiently inform supervisor of any challenge or barriers 4
relevant to given task or assignment
TOTAL 24

E. INITIATIVE TARGET RATING

1. Has the ability to complete assignment without the need of 4

prompting from the supervisor and others.
2. Successfully completes tasks independently and consistently 4
3. Seeks additional support necessary 4
4. Recognized and takes appropriate action to effectively address 4
problems and opportunities
5. Engages in continuous learning 4
6. Contributes new ideas and always seeks ways to improve the 4
department\organization
TOTAL 24

F. JUDGEMENT\DECISION MAKING TARGET RATING

1. Analyzes problems effectively 4

2. Demonstrates the ability to make creative and effective 4
solutions to problems
3. Demonstrate good judgment in handling routine problems 4
TOTAL 12

G. DEPENDABILITY \ RELIABILTY TARGET RATING

1. Has the ability to follow through and meet required deadlines 4
2. Is personally accountable for his\her environment 4
3. Adapt effectively to change in the work environment 4
4. Displays a consistent level of high performance 4
TOTAL 16

H. ATTITUDE TARGET RATING

1. Offers assistance willingly 4

2. Makes a positive contribution 4
3. Show sensitively to and consideration to other feelings 4
4. Accepts constructive criticism positively 4
5. Show pride in work 4
TOTAL 20

___________________________________________________________________________________________________________________________

Address: Purok 2 Ponggo, Nagtipunan, 3405, Quirino, Philippines

Contact Number: 09989726752
Email Address: 300662@deped.gov.ph
 I. PROFESSONALISM TARGET RATING

1. Respects those in authority 4

2. Uses all tools, equipment and machine responsibly 4
3. Follows all policies and procedures when issues and conflicts 4
may arise
4. Shows conductive physical appearance in work environment 4
and placement rules.
TOTAL 16

ACCUMULATED:160 TOTAL AVERAGE

Comments and Recommendations:

Supervisor’s Comments:

Supervisor’s Name & Signature

___________________________________________________________________________________________________________________________

Address: Purok 2 Ponggo, Nagtipunan, 3405, Quirino, Philippines

Contact Number: 09989726752
Email Address: 300662@deped.gov.ph