Sample Form for Board’s Evaluation of the Chief Executive

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The following is one sample form that might be used by the Board to evaluate the Chief Executive. This sample should be customized to the particular culture and purpose of the agency by modifying the performance criteria (in the following table) as appropriate for the organization, inserting those criteria in the table below, and conducting the evaluation using the updated table.

Directions:

1. The Board establishes a policy for evaluating the Chief Executive and establishes a current or ad hoc committee to carry out the evaluation. See “Guidelines for the Board’s Evaluation of the Chief Executive.”

2. Board, working with the Chief Executive, establishes performance criteria and inserts them in the table below. References organizational goals and the Chief Executive’s job description.

3. The Board assigns specific weighing factors for each of the major categories below. Factors depend on what the Board believes should be priorities for the Chief Executive during the evaluation period. The factors should total 100%. Example weightings might be finances 15%, revenue 20%, human resources 15%, products/programs 20%, facilities 10%, planning and governance 20%.

4. Each Board member and the Chief Executive completes the table below about the Chief Executive’s performance during the evaluation period. Each criteria is ranked from 1-5, with 1=unsatisfactory, 2 = partially within expectations, 3=meets expectations, 4=exceeds expectations, and 5= far exceeds expectations. This numerical ranking system tends to give perspective more than commentary. Rankings with commentary is ideal.

5. Multiply each ranking by the category’s weighting factor. Put the answer in the score column.

6. On a separate sheet of paper, provide any commentary that addresses rankings below 3. Consider adding commentary for high ratings as well.

7. Provide evaluation sheet and commentary to the Board member who is assigned to collate the sheets (usually the Board Chair).

8. The Board may decide to provide the Chief Executive an average ranking for each category. Similarly, commentary can be summarized or each comment provided to the Chief Executive.

9. The evaluation committee provides the evaluation report to the Chief Executive and schedules a meeting with him or her shortly thereafter.

10. Ensure the meeting is update and ends on a positive note.

11. Ensure plans are made to address ratings below 3, including specific actions by specific dates.

Sample Basic Form for Evaluating Chief Executive

Directions for use of this form are included on the previous page.

Name of Preparer	Ratings	Weight Factor	= Score
Finances, consider: · No loss of operating funds; no prolonged legal difficulties · Develops realistic budgets and stays within them · Maintains needed cash flow · Receives a “clean” financial audit *Comments:*
Revenue, consider: · Raises enough revenue to accomplish significant program goals and maintains or builds a financial balance keeping with organizational policy *Comments:*
Human Resources, consider: · Maintains or increases productivity of staff · Maintains sufficient and effective volunteer corps (nonprofits) · No undue staff turnover; no ongoing personnel complaints *Comments:*
Products/Programs, consider: · Maintains or expands programs per plans · Program evaluations demonstrate effectiveness · Meets yearly program goals and objectives *Comments:*
Facilities, consider: · Maintains professional surroundings and safe working environment *Comments:*
Planning and Governance, consider: · Has in place a clear mission statement and strategic plan · Maintains an active Board that provide good governance to the organization *Comments:*

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