PERFORMANCE DIALOGUE PLAN & APPRAISAL FORM
Employee Name:
Date:
Position:
Role (ex. PER1A, SAF2B, etc.):
Department / Unit:
Immediate Supervisor's Name:
Reference Period:
The Performance Dialogue Plan and Appraisal Form will be used to validate the merit recommendation of an
employee during the given fiscal period.
Please
review and
sign the lasthere.
page of this form at each stage of the
Enter the
employee’s
information
Performance Dialogue process. The signing of the staff member on this form attests that she/he has seen the content of
Additional information can be found on
this assessment, but does not necessarily confirm that he/she agrees with the assessment. The staff member is
the employee’s job description when
authorized to write an addendum document/letter to explain the reason of his/her disagreement with the assessment and
to ask that it be added to the originalneeded.
form.
Unit Objectives
Objectives should be SMART (Specific, Measurable, Achievable, Realistic, Timed). For examples, please visit the HR
Website under: http://www.mcgill.ca/hr/training/performance-dialogue
Note: Objectives can be reviewed and adjusted during the reference period following an agreement between the staff
member and the immediate supervisor.
Unit Objectives
We recommend that Unit Objectives be discussed at the beginning of the
reference period in order to ensure that the employee’s Individual Work
Objectives are well aligned with the University’s Mission.
Page 1
Individual Work
Objective # 1
Comments at Mid-Year Review:
Enter Individual Work Objectives in
the dedicated Objective boxes at the
Objectives
beginning of the reference period.
We have provided 3 boxes for 3
separate objectives, but you can
add more by copying and pasting
more boxes below.
Individual Work Objectives can also
be modified once discussed at the
mid-point check-in to reflect
changes in Unit priorities.
Comments at Year-End Review:
Objective # 2
Comments at Mid-Year Review:
Enter comments at the mid-point
check-in for each of the Work
Objectives in the dedicated
boxes. We recommend that you
keep a log of examples and
specific situations throughout
the year to clarify comments.
Comments at Year-End Review:
Page 2
Individual Work Objectives (cont.)
Objective # 3
Comments at Mid-Year Review:
Comments at Year-End Review:
Enter comments at the reference
period year-end for each of the
Work Objectives in the dedicated
boxes. We recommend that you
keep a log of examples and
specific situations throughout
the year to clarify comments.
Note: To add additional objectives, copy/paste the entire objective table block.
Although you can add additional boxes, we
recommend a minimum of 3 and a maximum
of 5 Work Objectives per reference period.
Page 3
Behavioural Competencies
For examples of competencies and position targeted levels per job family, please visit the HR Website under:
http://www.mcgill.ca/hr/sites/mcgill.ca.hr/files/competencies_for_all_m_families_at_mcgill_-_final_march_4_2015.pdf
Note: Employees and Supervisors must explore and agree upon 1 to 2 competencies that would be most valuable to
enhance the employee’s performance, job satisfaction, and career aspirations. Supervisors must also acknowledge
competencies that the employee demonstrates particularly well by providing specific examples.
Comments:
Change Agility
Expected Proficiency Level (A to D)
Embraces change
and improvement to
move the University
ahead
Choose a level
For each competency, indicate which proficiency
level the position requires the employee toComments:
be at.
Resourcefulness
Expected
Proficiency
Level
(A
to
D)
You can find this information using the
Gets things done
Choose a level
employee’s
Role and the Competencies Grid on
efficiently
and
resource-effectively
the Competencies Tools Web Site.
Page 4
Behavioural Competencies (cont.)
Comments:
Teaming
Expected Proficiency Level (A to D)
Contributes to or
builds effective
teams
Choose a level
Managerial
Courage
Expected Proficiency Level (A to D)
Makes and stands
behind tough
decisions
Self-Awareness
and Management
Practices emotional
Maturity
Comments:
Choose a level
During the mid-point check-in and during the
reference period year-end, enter comments for
1 or 2 competencies that the employee
demonstrates particularly well.
Expected Proficiency Level (A to D)
Choose a level
During the mid-point check-in and during the
reference period year-end, enter comments for
Comments:
1 or 2 competencies that the employee would
benefit from enhancing.
We recommend that you keep a log of examples
and specific situations throughout the year to
clarify comments.
Page 5
Behavioural Competencies (cont.)
Client Service
Orientation
Provides excellent
service to students,
staff, the community,
and internal clients
Performance
Orientation
Takes ownership of
or fosters
accountability for
delivering results
Comments:
Expected Proficiency Level (A to D)
Choose a level
Comments:
Expected Proficiency Level (A to D)
Choose a level
Page 6
Training and Development
Technical Skills and/or behavioural skills to develop
Method(s) by which the skills will be developed
Enter discussed training
opportunities here (classes,
workshops, books, etc.). Use
the Competencies Toolkit for
guidance on the Competencies
Tools Web Site.
Career Aspirations and Associated Development
Discuss the employee’s career
aspirations throughout the
year and document whether or
not they are on track here.
Page 7
The Performance Dialogue Plan and Appraisal Form will be used to validate the merit recommendation of an
employee during the given fiscal period. Please review and sign the last page of this form at each stage of the
Performance Dialogue process. The signing of the staff member on this form attests that she/he has seen the content of
this assessment, but does not necessarily confirm that he/she agrees with the assessment. The staff member is
authorized to write an addendum document/letter to explain the reason of his/her disagreement with the assessment and
to ask that it be added to the original form.
Performance Dialogue Plan
Date:
Employee’s Signature:
Date:
Immediate Supervisor's Signature:
Date:
This is a sign-off page. Please
ensure that both the supervisor
and employee sign this same page
throughout the year:
Performance Dialogue Mid-Year Discussion
Date:
1. When they
establish
objectives
at the beginning
Date:
of the reference period.
2. When they
meet at the midDate:
point check-in.
3. When they appraise
objectives at the end of the
reference period.
Date:
Employee’s Signature:
Immediate Supervisor's Signature:
Performance Dialogue Year-End Appraisal
Employee’s Signature:
Please check this box
and clickSignature:
on the link if
Immediate Supervisor's
you feel the employee
could benefit from a
detailed and
documented coaching
plan.
Date:
Date:

Requires Performance Coaching Plan
Page 8