E/PKK/OPM/02 Rev 0/July '10

PT. WINTERMAR
(WORLDWIDE INTERNATIONAL MARINER CO.LTD.)

EMPLOYEE EVALUATION FORM

Name: Position: Department: NIK: Evaluated by: Position: Department: NIK: Date: Sign:

CRITERIA Personality
1 2 3 4 5 6 7 Dedication to job Loyalty to Company Self motivation and enthusiasm towards job General appearance and presentation Ability to motivate others Organisational skills of work, files, data, reports. Responsibilty Poor 0 0 0 0 0 0 0 Poor 0 0 0 0 0 0 0 Poor 0 0 0 0 0 0 0 Poor 0 SUB TOTAL

EVALUATION SCORE
Sufficient 1 1 1 1 1 1 1 Sufficient 1 1 1 1 1 1 1 Sufficient 1 1 1 1 1 1 1 Sufficient 1 Good 2 2 2 2 2 2 2 Good 2 2 2 2 2 2 2 Good 2 2 2 2 2 2 2 Good 2 Excellent 3 3 3 3 3 3 3 Excellent 3 3 3 3 3 3 3 Excellent 3 3 3 3 3 3 3 Excellent 3

REMARKS

Work
8 9 10 11 12 13 14 Decision making Planning ability Time management Professionalism towards job Quality of work Quantity of work Productivity

Communication Skills
15 16 17 18 19 20 21 Ability to work together as a team Ability to give / receive clear instructions Ability to share knowledge Input during meetings Knowledge of job Clarity and professionalism of email, letters & memos Communicating in English

Attendance
22 Attendance and punctuality

TOTAL SCORE

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E/PKK/OPM/02 Rev 0/July '10

Praise for the employee

Complaints about the employee

Special record regarding the employee (positive & negative)

Areas to be improved

Accepted by: Managing Director

Sign: Date:

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