Employee Work Profile Employee Self-Assessment

Employee Name:
Supervisor Name:	Performance Period:

Core Responsibilities	Core Responsibilities - Comments on Results Achieved
A.
B.
C.
D.
E.
F.
G.
H.

Special Assignments	Special Assignments - Comments on Results Achieved
A.
B.
C.
D.
E.
F.

Agency/Department Objectives	Agency/Department Objectives - Comments on Results Achieved
A.
B.
C.

Other Significant Results for the Performance Cycle

Employee Development Results

Employee Signature:	Date: