ACT OF 1974, I UNDERSTAND THAT MY WORK IS NOW BEING EVALUATED. I HAVE THE RIGHT TO REVIEW ANY DOCUMENTAION REGARDING MY EVALUATION, AND I HAVE THE RIGHT TO REQUEST AMENDMENT TO AND/OR MODIFICATION OF ANY SUCH DOCUMENT.



NAME________________________________DATE___________
DEPARTMENT_____________________________________________

KNOWLEDGE


ACCURACY


ATTITUDE


RELIABILITY


PERFORMANCE


LEADERSHIP


I HAVE READ AND UNDERSTAND MY EVALUATION, AND WILL ATTEMPT TO CORRECT ANY DEFICIENCIES, IF I FEEL LIKE IT.

____________________________________________________
EMPLOYEE'S SIGNATURE



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