Sweet Briar College
PERformance Checkup (PERC) Instructions
Salaried Employees Form - Revised 2-2010
The PERC forms are tools to assist employees and management in communicating performance-related issues. The
PERC process is intended to be a two-way communication, which serves as a check-up, much like an annual visit to
the doctor's office. While employees should be receiving feedback during the entire review period, this is an
opportunity to summarize performance, set goals for the next period and thank the employee for their contribution.
PLEASE NOTE THAT THE REVIEWER’S SUPERVISOR SHOULD SIGN THE COMPLETED FORM BEFORE IT IS
DISCUSSED WITH THE EMPLOYEE. PLEASE ALLOW ADEQUATE TIME FOR THIS SECONDARY REVIEW.
Suggestions for completion:
1) Provide the PERC Preparation Form to the employee and ask them to respond in writing to the questions and
return the responses to you. Their responses will be helpful to you in completing the PERC form, and in
developing future priorities. The amount of time that is provided to the employee may vary some, but in general a
minimum of three days should be allowed. Notify the employee that their responses will be attached to their PERC
2) Review notes relative to the employee: Since the PERC form is normally used as part of an annual check-up,
the next step in the evaluation should be a review of any documentation, notes, projects, goals, etc. which were
pertinent to the review period (usually the last year).
3) Review expectations for the job, including job descriptions, performance standards, or anything else that
provides information concerning the expected performance level or accomplishments. This is a good time to
update the job description so that it accurately reflects changes in the employee’s job responsibilities.
4) Gather input: this may include statistics or data, but may also include comments from others who work closely
with the employee. If you choose to solicit input from others, please consider the following:
In order to ensure the input is valued by the employee, the supervisor and employee should jointly select
individuals who would have knowledge of the employee’s work.
Comments made by third party reviewers should be anonymous. The supervisor still retains responsibility
for ensuring that comments are valid, and for summarizing them in a way that will provide value for the
Comments from third parties may be sent via email or paper. If verbal input is received, the supervisor
should document the comment for his/her own records. Please take precautions to preserve the
confidentiality of any of this information.
Input from others may be solicited for just one category of performance, or for a number of categories,
depending on the individual’s level of interaction with the employee.
5) Complete the form. Consider the employee's performance relative to stated goals and expectations. Section #1
may be completed either by using the chart on page two of the review form, or by submitting a narrative which
addresses these same categories. It may be helpful to complete a draft of the PERC form before you receive the
employee's completed Preparation Form, and then finalize the draft after you have reviewed it.
6) Consider any attachments that might be appropriate. If there is additional performance-related documentation
that is pertinent to the review, feel free to attach it. Do not include comments made by third party reviewers unless
they have specifically asked that you do so.
7) Establish a date for a follow-up review, if needed: This typically is only required in situations where there is
significant improvement needed in a particular area, or for employees new to their position.
8) Obtain the signature of approval from the secondary reviewer. The reviewer's supervisor should review the
form and sign it, prior to delivery to the employee, to ensure consistency within the department or division .
9) Discuss the PERC form with the employee, and listen to his/her comments related to the PERC prep form.
Discuss areas for improvement, and steps that will be taken by either party. Identify priorities and goals for the
coming year, as well as developmental needs. If there are any additional comments that seem appropriate to add
to the form after your discussion, please add or attach these. The employee may make additional comments as
10) Sign the form, and ask the employee to sign the form. The employee’s signature indicates that the document has
been reviewed with them.
11) Make a copy for the employee. Keep a copy for the departmental file, if you wish, and return the original forms
to Human Resources in a sealed, confidential envelope.
Sweet Briar College
PERformance Check-up (PERC)
For Salaried Employees
Employee Name__________________________________ Position Title _____________________________________
1. Please comment on the following aspects of the employee’s performance as well as any other
pertinent areas: Key Accomplishments and Contributions, Job Knowledge, Quality of Work, Quantity of Work,
Interpersonal Relations, Use of Resources, Initiative & Problem-solving, Adaptability/Versatility, Leadership & Supervision
(if applicable). Use the attached form, or a separate page, if desired. Please either attach or list goals that were to be
achieved this year.
2. Additional comments related to performance:
3. Goals and priorities for coming year:
4. Suggestions for skill or professional development, including workshops or classes, technology
Workshops or seminars:_________________________________________________________________
Certifications, degrees, etc:_______________________________________________________________
Other professional or skill development ______________________________________________________
Supervisor/Reviewer's Signature: Date
Signature of Reviewer's Supervisor Date
Employee's Signature* Date
*Your signature indicates you have participated in the Performance Checkup session; it does not necessarily indicate agreement. If
you have additional comments related to your PERC session, please make them on an additional page, and attach.
Date Received in HR_____________ reviewed by ____________ □ PEAREVW _______
Key Accomplishments and
Including progress towards
previously established goals
(please attach or list goals that
were to be achieved)
Quality of Work
Quantity of Work
Consider interactions with
colleagues, clients or
customers, students, faculty,
parents, alumnae or other
Use of Resources
Including use of training
resources, technology and
equipment, internal or external
Initiative & Problem-
Consider creativity, decision-
Response to change and new
Leadership & Supervision
Extent to which the employee
inspires others, expresses
vision, provides direction or
supervision of others
Other areas (please
Sweet Briar College
PERformance Checkup (PERC)
Employee Name______________________________Job Title__________________________________
The questions below are intended to assist you in preparing for your Performance Checkup session. Please use the space below to
make any comments you have related to your job or your performance, and submit the completed form to your immediate supervisor
prior to the PERC session. This copy will be submitted to Human Resources along with your other PERC forms. Please respond based
on your job experiences within the last year, or since your last PERC session. In developing your responses, please consider how your
job contributes to the overall mission of the college. (Feel free to use an additional page if necessary).
1. My goals for this year were:
2. The significant changes (if any) to my job this year have been:
3. My greatest accomplishments or strengths this year have been:
4. The activities or efforts that were less successful or disappointing this year were:
5. The environmental or other factors that affected my job this past year were:
6. These are the things I enjoy most about my present job:
7. My supervisor or co-workers could do the following to help me in my job:
8. I would like more experience, training, or responsibility or education in the following areas:
9. We could enhance Sweet Briar College by:
10. I believe my goals for the coming year should be:
11. Other suggestions or comments :