Appraisal Form: Sample Document

Article modified: June 2015, Author:

Please note that our sample documents are intended as examples which can act as starting points and prompters. They should not be taken as definitive, complete or even sufficient for your purposes – you should at the very least consider how your circumstances (requirements, organisational structure etc) differ. But they are better than a blank sheet!


What you cover in an appraisal will depend to a large extent on how management works in the organisation over the rest of the year. If there aren’t regular supervisions sessions, or similar, issues like time keeping, sickness record, understanding of work objectives and standards ought to be included somewhere.

Part One

Appraisal Checklist

Questions to be considered and anwered by the appraisee before the appraisal session:

How accurately does your job description describe the job you do? What changes could be made to the job description in order to reflect the job you are doing?

What are your main achievements of the last twelve months?

What would you like to have achieved over the last twelve months but have been unable to do so? What prevented you from doing so?

What has gone well over the last year, and why?

What has not gone well over the last year, and why? How can the situation be improved in the coming year?

What specific targets do you think you can achieve over the coming year? These can include your current areas of work or new areas of work which you would like to take on.

What do you need from the organisation to help you reach these targets?

Can you identify any specific areas where training would help you improve your performance?

Are there any other issues you would like to raise? These can include any ideas or concerns you have either with your career, your role, your management, or with the organisation in general. Please be a specific as possible.


Part Two

Appraisal Form

Name (appraisee) __________________________

Job Title _________________________________

Line Manager/Appraiser _____________________

The following should indicate dates for achievement/action and who to do, where appropriate.

  • Agreed targets for the year:
  • Agreed training needs:
  • Other action points (including any amendments to job description):

Line manager comments

Job holder comments

Director’s comments

Signed __________________________ Job holder. Date:

Signed __________________________ Line manager. Date:


Copies to be kept by both parties (during following year) and on personnel file.

Creative Commons Licence
This work is licensed under a Creative Commons Licence.