Professional and Scientific
Performance Evaluation
Iowa State University
Extension and Outreach
Name:
Date of Evaluation:
Time period covering:
1. List goals and accomplishments toward goals established during performance evaluation time
period. Please include any new goals established during this time period.
Goal Category
Goal
Progress
2015 Goal
2015 Goal
2015 Goal
2015 Goal
2. Since the last evaluation period, have you performed any new tasks or additional duties outside the
scope of your regular responsibilities? If so, please specify.
3. What activities have you initiated, or actively participated in, in an effort to encourage camaraderie
and teamwork within your department and/or office? What was the result?
4. Describe any professional development you participated in and how doing so enhanced your
performance.
5. Describe any areas you feel require improvement in terms of your professional performance. List
steps you plan to take or resources you need to accomplish this.
6. Describe how you implement a “customer focus” strategy both in ways both internal and external to
your department. How do you plan to enhance this in the upcoming year?
7. List specific, measurable, attainable, realistic, and time-oriented goals for the next year. Both
professional development and programming goals should be addressed. Civil Rights should be
incorporated into at least one programming goal.
Goal Category
Goal
Progress
2016 Goal
2016 Goal
2016 Goal
2016 Goal
ADDITONAL COMMENTS:
Conflicts of Interest and Commitment (COIC) Disclosure
I have completed the ISU annual disclosure of COIC in the AccessPlus system. Y_____ N______
If no, anticipated completion date: ______________
Employees shall disclose electronically via AccessPlus at the beginning of employment and thereafter
at least once pre year, generally in the month of January, and whenever the employee’s situation
changes. Per ISU Conflicts of Interest and Commitment Policy, disclosures shall be made prior to the
initiation of external activity.
TO BE COMPLETED BY SUPERVISOR:
Overall Performance Rating:
_________ Exceeds Expectation
_________ Meets Expectation
_________ Needs Improvement (a Performance Improvement Plan must be initiated)
Supervisor Comments:
Supervisor’s signature __________________________________________ Date ____________
Employee’s signature ___________________________________________ Date _____________
Signature by employee does not imply agreement with statements contained in the evaluation, only that the employee has
read and discussed the evaluation with his/her supervisor.