Provided here is an example of a form used to gather feedback from peers or clients on the performance of a program assistant.
Prepared by Carolyn Manning, Story County Extension Education Director
Confidential: Your identity will not be revealed except to supervising staff. You may be contacted for additional information.
Iowa State University - Story County
Youth and 4-H Coordinator Performance Appraisal
_______________________________ Date: _______
Name of Staff Member
Being Evaluated
Levels of Success:
7=Far above Successful level
6=Moderately above Successful level
5=Slightly above Successful level
4=At Successful Successful level
3=Slightly below Successful level
2=Moderately below Successful level
1=Far Below Successful level
0=Did not observe
|
Appraisal Factors |
Level of success (circle number) |
|
Clientele are satisfied with assistance provided |
7 - 6 - 5 - 4 - 3 - 2 - 1 - 0 |
|
Prompt and courteous service to clientele |
7 - 6 - 5 - 4 - 3 - 2 - 1 - 0 |
|
Uses good judgment in determining best way to assist client |
7 - 6 - 5 - 4 - 3 - 2 - 1 - 0 |
|
Works as a team member with other extension staff and volunteers |
7 - 6 - 5 - 4 - 3 - 2 - 1 - 0 |
|
Enthusiastic about the job |
7 - 6 - 5 - 4 - 3 - 2 - 1 - 0 |
|
Markets and promotes ISU Extension as a credible source of unbiased, research based information and education |
7 - 6 - 5 - 4 - 3 - 2 - 1 - 0 |
|
Businesslike and professional appearance and attitude |
7 - 6 - 5 - 4 - 3 - 2 - 1 - 0 |
|
Programming reflects the use of creative and innovative ideas to solve problems |
7 - 6 - 5 - 4 - 3 - 2 - 1 - 0 |
|
Utilizes volunteers effectively |
7 - 6 - 5 - 4 - 3 - 2 - 1 - 0 |
|
Is effective in youth recruitment |
7 - 6 - 5 - 4 - 3 - 2 - 1 - 0 |
|
Ability to organize work and program |
7 - 6 - 5 - 4 - 3 - 2 - 1 - 0 |
Person Completing Form: _________________________ Position : ____________________
Areas of Greatest Strength:
Areas Needing Improvement:
Suggestions:
Other Comments: