PERFORMANCE APPRAISAL FORM
P.O. BOX 1, KYAMBOGO
                        Tel: 0414-286452, Fax: 041-220464
                  Email: dhr@kyambgo.ac.ug, www.kyambogo.ac.ug
                        Directorate of Human Resources
                                                     Appraisal Form
Preamble
Staff Performance Appraisal is part of the Performance Management System of Kyambogo University. It is used as a
management tool for establishing the extent to which set targets within overall goals of the University are achieved. Through
staff performance appraisal, performance gaps and development needs of an individual employee are identified. The
appraisal process offers an opportunity to the Appraisee and Appraiser to dialogue and obtain a feedback on performance.
This therefore, calls for a participatory approach to the appraisal process.
The Appraiser and Appraisee are therefore, advised to read the detailed guidelines before filling this form.
                                   DD              MM              YYYY               DD            MM         YYYY
Period of Assessment: From                                                       To
SECTION A: PERSONAL INFORMATION (To be filled by the Appraisee)
Name of the Appraisee ___________________________________________________________________________
                                     DD              MM             YYYY
Date of Birth
Job Title ______________________________________________ Salary scale _________________________
                                                DD          MM              YYYY
Date of Current Appointment
Terms of employment (Probation, Permanent, Contract):_______________________________________________
If contract or probation indicate start date: ___________________ end Date: ________________________
Name of the Appraiser:__________________________________________________________________________
Appraiser’s Job Title:_____________________________________ Salary scale: ____________________________
Division/section: _______________________________________________
Department: __________________________________________________________________________________
Faculty (where applicable): ______________________________________________________________________
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PERFORMANCE APPRAISAL FORM
SECTION B: ASSESSMENT OF THE LEVEL OF ACHIEVEMENT
This section should be filled by both the Appraiser and the Appraisee. At the beginning of each assessment period, the Appraiser and Appraisee will agree on the key outputs for the
assessment period. The means by which performance shall be measured (Performance Indicators) and the minimum level of performance (performance targets) for each output shall
be agreed upon. If in the course of the assessment period, other activities are assigned to the Appraisee, the outputs related to the new activities should be agreed upon and included
immediately or at least before the end of the assessment period. It is recommended that the maximum number of outputs for each assessment period should not exceed 10.
At the end of the assessment period, an appraisal meeting should be conducted by the Appraiser. The Appraisee completes part B(1); before the appraisal meeting, by indicating the
key outputs, performance indicators and targets agreed upon in the performance plan at the beginning of the assessment period. The Appraiser should complete part B(2), after the
appraisal meeting. The assessment should reflect the jointly agreed position.
The assessment of the Individual outputs shall be reflected as a performance level under section B(2); this will be supported by relevant comments on performance under the same
section. The performance levels shall be described as Excellent, Very Good, Good, Fair and Poor. In order to quantify the assessment, the performance levels shall be awarded
scores namely; 5 for excellent, 4 for Very Good, 3 for Good, 2 for fair and 1 for Poor. Right after the table below is a detailed description of the performance levels.
                                            B (1)                                                                                     B (2)
                    Agreed Key Outputs, performance Indicators and Targets                                                   Assessment of Performance
                         Performance Indicators              Performance targets              Self             Supervisors        Agreed Rating     Comments of Performance
 Key Outputs             (How will results be measured)      (An agreed minimum level of      Rating           Rating
                                                             performance)
 TOTAL
 OVERALL SCORE
                                                                                          2
PERFORMANCE APPRAISAL FORM
DEFINITION OF THE PERFORMANCE LEVELS
Excellent (5):            The Appraisee has exceeded the agreed targets and has consistently produced results of excellent quality and demonstrated
                          a high level of productivity and timeliness.
                          The Appraisee is a model of excellence in both the results achieved and the means by which they are achieved.
Very good (4):            The Appraisee achieved all the agreed output in line with the agreed targets. The Appraise consistently meets expectations
                          for the out puts achieved and the means by which they are achieved.
Good (3):                 The Appraisee achieved most, but not all the agreed out puts in line with the agreed targets, and there is no supporting
                          rationale for not meeting the other commitments.
Fair (2):                 The Appraisee has achieved minimal outputs in line with the agreed and without a supporting rationale for inability to meet
                          the commitments.
Poor (1):                 The Appraisee has not achieved most of the agreed targets and without supporting rationale for not achieving them.
Overall Assessment of Performance
Overall assessment of performance should be derived by adding the scores at each performance level and the total divided by the total number of outputs. The average of the scores
obtained shall be the overall assessment.
Overall Performance Level               Excellent    Very Good       Good        Fair          Poor
                                           5             4            3           2             1
Tick the relevant box
                                                                                        3
PERFORMANCE APPRAISAL FORM
SECTION C: ASSESSMENT OF CORE COMPETENCIES
This section should be filled by the Appraiser after joint discussions between the Appraiser and
Appraisee. The assessment will help establish any areas where some training or development is
necessary. The Appraisee should be rated only in areas, which are relevant to his/her job. The maximum
points per competence are 5, where 5 is for Excellent, 4 - Very Good, 3 - Good, 2 - Fair, 1 – Poor,
N/A - Not Applicable. The Appraiser should give work related examples under comments, to justify
their rating.
 COMPETENCE                                                                ASSESSMENT             COMMENTS
                                                                           Performance level
                                                                           attained
                                                                           (Please tick)
                                                                           5 4 3 2 1 N/A
 Professional knowledge/skills
 Draws on own experience, knowledge and expertise to demonstrate
 good judgment; relates professional knowledge to work.
 Planning, organizing and coordinating
 Prioritizes own work, develops and implements plans; rationally
 allocates resources, builds group capacity for effective planning and
 executing of work. Has ability to meet deadlines.
 Leadership
 Keeps people informed; models and encourages personal
 accountability; uses power and authority fairly; demonstrates credible
 leadership, champions new initiatives; reinforces and communicates a
 compelling vision for change.
 Decision Making
 Makes logical analysis of relevant information and factors; develops
 appropriate solutions and takes action, generates ideas that provide
 new insight; provides reasons for decision or actions, is objective.
 Team work
 Works cooperatively and collaboratively; builds strong teams; shares
 information and develops processes to improve the efficiency of the
 Team.
 Initiative
 Shows persistence by addressing current problems; acts proactively,
 plans for the future and implements comprehensive plans.
 Is open to new ideas; curious about and actively explores new
 possibilities; identifies how to create more value for customers; takes
 action on innovative ideas and champions innovation.
 Communication
 Actively listens and speaks respectfully; seeks to send clear oral and
 written messages; understands the impact of messages on others.
 Result Orientation
 Takes up duty willingly and produces results.
 Integrity
 Communicates values to others, monitors own actions for consistency
 with values and beliefs, takes pride in being trust worthy; is open and
 honest and provides quality services without need for inducements.
                                                     4
PERFORMANCE APPRAISAL FORM
 Human Resource Management
 Works effectively with people to achieve organizational goals.
 Motivates the supervisees, focuses on the knowledge, skills and
 attitudes and the general work environment that affects their efficiency
 and effectiveness. Trains, mentors, coaches, inspires, motivates the
 supervisees, delegates effectively and are able to build a strong
 working team.
 Financial Management
 Knows the basic financial policies and procedures; familiar with the
 overall financial management processes.
 Management of other resources (equipment & facilities)
 Effectively and efficiently uses resources to accomplish tasks.
 Time Management
 Always in time and accomplishes tasks in time required and maximizes
 the use of time to achieve set targets.
 Customer care
 Responds well and attends to clients. Reflects a good image for the
 University.
 Loyalty
 Complies with lawful instructions of Supervisor and is able to provide
 ongoing support to Supervisors.
 Any other relevant Competence
SECTION D: ACTION PLAN TO IMPROVE PERFORMANCE
The Action Plan shall be jointly agreed during the performance appraisal meeting, taking into
consideration the Appraisee’s required job competences and the identified performance gaps.
The action plan to improve performance may include; Training, Coaching, mentoring, attachment, job
rotation, counseling and or provision of other facilities and resources.
Where the plan(s) involve formal training of the Appraisee, the record should be forwarded to the Staff
Development Committee through the Director Human Resources.
                                                    5
PERFORMANCE APPRAISAL FORM
Performance Gap                                          Agreed Action                          Time frame
SECTION E: COMMENTS, RECOMMENDATIONS (IF ANY) AND SIGNATURES
This section is to be completed by the Appraisee, Appraiser and the counter signing Officers. It is a
confirmation that the appraisal meeting took place and that there was agreement or if there was
disagreement, it was resolved. It is also confirmation that the action plan to improve performance was
discussed and agreed upon. The Appraisee / Appraiser / countersigning officer should use this section to
comment about the job, career and any other relevant information.
Describe how effectively you have been utilized by the University.
How would you like Management to assist you improve your performance?
List the skills and training you need in order to improve performance.
What are your aspirations in terms of career development?
Any other general comments?
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PERFORMANCE APPRAISAL FORM
                                                  DD   MM   YYYY
Signature:_____________________________________
COMMENTS OF THE APPRAISER
                                                  DD   MM   YY
 Signature ____________________________________
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PERFORMANCE APPRAISAL FORM
COMMENTS OF THE COUNTERSIGNING OFFICER/SUPERVISOR OF APPRAISER
Name of Countersigning Officer: _______________________________________________________
Job Title: ___________________________________________________________________________
                                                     DD             MM         YY
     Signature:___________________________________
 _
COMMENTS OF THE RESPONSIBLE OFFICER (DHR/University Secretary/Vice Chancellor)
Name: (DHR/US/VC): __ ___________________________________________________________
Job Title: ___________________________________________________________________________
                                                     DD             MM         YY
 Signature: _______________________________