Schedule -1
(Relating to Sub-Rule 1 of Rule 32)
Work Performance Evaluation Form
Guidelines to fill in the form:
1. Each teacher shall fill in this form having filled in the particulars to be
filled in by him and submit it to the Headmaster of his/her school within
30 days from the date of beginning of each academic year. If no form is
submitted, his/her name shall be removed from the probable list of
promotion.
2. Within 15 days of the receipt of the form, the Headmaster shall forward
it to the District Education Office having completed his/her tasks and
along with his/her reaction.
• 3.
The District Education Officer shall completed his/her tasks of
supervision and review within two months and forward the form to the
Regional Education Directorate or the Commission as the case may be.
The Regional Education Directorate shall complete its tasks of review
within two months and forward it to the Commission.
Name of School to which the particulars are submitted: –
Registration No. Date: –
1. Personal particulars: Period of evaluation: from ………. to ..
Name and Address of Teachers: –
Permanent Address: –
Post ……………………….Level ……………………..Class
Name of school: –
District: –
Address: – Municipality .VDC……………Ward .No. …….. Place………………
Date of appointment (Enclose the copy)…………. Temporary:-…..
Academic qualification (Enclose copies of certificates)
Examination passed Name of the Organization Year Division
• Amended by First Amendment.

1.
2.
3.
4.
5.
Trainings (Enclose copies of certificates)
Name of Training Name of organization giving certificate Duration
Class
1.
2.
3.
2. Details of works
Detains of remarkable works performed by the teacher (To be filled in
by the teachers)
(Details of special acts relating to teaching, extra activities, physical and
financial reform of school, upgrading quality of education)
1.
2.
3.
Signature of the teacher:-
Date:-
It is herby certified that aforementioned personal details of the teacher
are true and correct.
3. To be filled in by Headmaster:
1. Remarkable acts he/she has performed during this academic year:-
1.
2.
3.
2. Opinion of the Headmaster with regard to his regularity of
presence in schools quality of teaching participation in school
programs and discipline:-
Signature of Headmaster: –
Name:-
Date:-
4. Work efficiency evaluation:-
Ten qualities that a teacher must have are stated here. According of the
degree of each quality, the following marks may be given:-
Marks to be given by the first supervisor
Excellent – 2 marks Good 1.5 marks
Satisfactory – 1 Marks General: 0.5 marks
Marks to be given by the second supervisor:
Excellent – 1 marks Good: 0.75 marks
Satisfactory – 0.50 marks Normal: 0.25 marks
Marks to be given by the reviewing authority
Excellent –1 marks Good: 0.75 marks
Satisfactory –0.50 marks Normal: 0.25 marks