HTML Preview Appraisal Form Sample page number 1.
Confidential
Staff Performance Appraisal
Form B
The purpose of this appraisal form is to provide a written record for the staff member and his or her
supervisor on the nature of the former’s job and his or her performance in it. Supervisors are urged to
be frank in their evaluations both for the benefit of the staff member and for the accuracy of this
appraisal record. This appraisal will become a part of the staff member’s personal file.
Staff Member
Job Title
Department/Office
Supervisor
Appraisal Period
Date of Appraisal
I. MAJOR RESPONSIBILITIES: List the major responsibilities of the staff member’s position in approximate
order of importance. After you complete this section, forward this form to your supervisor.
Sections II, III, and IV are to be completed by the supervisor.
II. SUPERVISOR’s REVIEW OF RESPONSIBILITIES: Review the above list of major responsibilities and note
your concurrent or comment on any additions, deletions, or changes in priority that you feel are appropriate.
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