Oregon State University

Ex1: Student Employee Work Performance Summary

Student Employment Policy & Procedure Manual
Section 100: Introductory Material
Effective: 08/01/2005




Name of Employee:                                John Doe                                                  

Department:                Chemistry                                                               

Position Title:    Student Office Worker                 Report Period:  From___/___/___ Through ___/___/___

Rating For: (check one) Periodic      √         Merit  ______   Termination  _______

(If additional space is needed for comments, you may add extra pages.)

I.    SUMMARY OF WORK PERFORMED: (Summarize employee’s performance during the appraisal period relating to the duties listed in position description.)

Completes all work assignments in a timely and competent manner.


II.    BEHAVIORAL FACTORS SUMMARY: (Refer to instructions.)

Follows instructions well, makes independent decisions using good judgment, gets along with employees well, very energetic and upbeat, pleasant to be around.


III.   EMPLOYEE DEVELOPMENT EXPERIENCES: (Summarize the results of employee development experiences during the appraisal period for increasing effectiveness in present position or for future development.)

John has become more productive as he gains experience in this field.  He performs his work well with minimal supervision and guidance and takes on additional responsibilities for the good of the department.  John is a valuable asset to the department.


IV.  DEFICIENT PERFORMANCE: (Describe employee’s failure to overcome deficient performance or conduct during the appraisal period.)

Not applicable


V.    APPRAISAL SUMMARY: (Check one category.)

    √    Makes outstanding contribution in critical areas while meeting all major requirements of the position
          Performs requirements of the position in a satisfactory manner
          Fails to meet performance requirements of the position in major or critical areas

Your signature below indicates that this report was discussed with employee/employer and the employee has received a copy.  This form is to be placed in the employee's personnel file in the department.


          John Doe                                 4/1/2003               George Washington        4/1/2003
Student Employee Signature             Date                    Supervisor                            Date

Date Rev. 1/12/2004

Link to actual Student Employee Work Performance Summary Form

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