ATLANTA POLICE DEPARTMENT

PERIODIC REVIEW FORM
ADMINISTRATIVE DATA
1. (Name) Last, First, MI

2. Job Class Title

3. Appraisal Month

4. (Supervisor’s Name) Last, First, MI	5. Job Class Title	6.	Select if employee is borrowed personnel
7. Type of Appraisal (select appropriate block(s)): Quarterly Reviews 1st Qtr 2nd Qtr 3rd Qtr

New Civilian Hire Probationary: 2nd 4th Performance Probation ( 1st, 2nd, 3rd, 4th, 5th) Newly Sworn Police Officer ( 1st, 2nd, 3rd, 4th, 5th) Sworn Promotion: ( 1st, 2nd, 3rd, 4th, 5th,

6th, 7th, 8th, 9th, 10th, 11th) Non-sworn Promotion: ( 1st, 2nd 3rd 5th)
CRITICAL JOB ELEMENTS/PERFORMANCE INDICATORS (provide justification for each rating)
CJE #1: Outstanding Highly Effective Effective Needs Improvement Unacceptable

CJE #2: Outstanding Highly Effective Effective Needs Improvement Unacceptable

CJE #3: Outstanding Highly Effective Effective Needs Improvement Unacceptable

CJE #4: Outstanding Highly Effective Effective Needs Improvement Unacceptable

CJE #5: Outstanding Highly Effective Effective Needs Improvement Unacceptable

Overall Rating: (use overall rating chart matrix)

Outstanding Highly Effective Effective Needs Improvement Unacceptable

Employee’s Signature & Date
Supervisor’s Signature & Date

APD Form 235

CITY OF ATLANTA: POLICE DEPARTMENT

JReynolds

2004-07-22

AJordan

Atlanta Police Department