Probationary Appraisal Form

Name:	Department:
Title:	Supervisor:
Grade:	Supervisor’s Title:
DOH in Position: Date:

Please indicate whether the staff member has fulfilled your expectations regarding the competencies listed below. In addition, please note your recommended action with respect to the staff member’s employment with the University. Please note that comments are only required for Does Not Meet Expectations.

Institutional Values	Meets Expectations ☐	Does Not Meet Expectations ☐
Projects a positive image of Brown Embraces the University’s commitment to maintain a diverse and inclusive workplace Adheres to University policies and procedures Demonstrates commitment to the Strategic Plan, department goals and/or mission.	Comments:
Collaboration	Meets Expectations ☐	Does Not Meet Expectations ☐
Serves as a positive team member and/or colleague Treats co-workers with respect, honesty and fairness Establishes productive working relationships Is flexible and adapts to changing priorities resolves conflicts effectively	Comments:
Communication	Meets Expectations ☐	Does Not Meet Expectations ☐
Communicates verbally and in writing at a level appropriate for his/her position Follows instructions and shares information if appropriate Engages in meaningful, two-way conversations Speaks effectively, understands others, listens attentively and clarifies information when necessary	Comments:
Accountability	Meets Expectations ☐	Does Not Meet Expectations ☐
Shows initiative; takes ownership of all responsibilities Seeks input and acts upon feedback Enhances personal knowledge, skills and abilities Follows through on responsibilities and tasks in an effective manner Is reliable and responsible	Comments:

Service	Meets Expectations ☐	Does Not Meet Expectations ☐
Is accessible, offers assistance and support Responds in a timely and helpful manner Strives to provide exceptional service Demonstrates positive behavior and demeanor Promotes cooperation, collaboration and flexibility with contacts and colleagues	Comments:
Job Knowledge	Meets Expectations ☐	Does Not Meet Expectations ☐
Has an understanding and an aptitude for the major duties and responsibilities of the position Completes assignments in a thorough, efficient and consistent manner Uses technology when available and appropriate Exercises sound judgment when carrying out responsibilities Has mastery of major duties appropriate to time in the position	Comments:

Recommended Action

☐Continue employment as regular employee

☐Extend Probationary Period*

☐Terminate Employment*

*Consult with your assigned HR Generalist prior to discussing your recommended action with the staff member.

Signatures and verifications

I have reviewed this probationary appraisal with my supervisor and was given an opportunity to provide comments.

Staff Member Printed Name Staff Member Signature Date

I have drafted and discussed this probationary appraisal with the above named staff member.

Supervisor Printed Name Supervisor Signature Date

Please return a completed copy of this form to University Human Resources (Box 1879) seven days prior to the end of the staff member’s probationary period.

UHR Use Only

Rec’d By: ______________________ Date: _____________