9. Appendix I Sample of academic and support staff appraisal forms

5

................ Affiliation:..............................................

ults (2) Assessment scores Competency
gaps

Exceeds Average Percentage (5)
ns expectations Outstanding (3) (4)

f Number of Number of
* Committee* Committee*

ment Score x Weighted Value (20 points) = ……. x 20

____________________________ 900
Number of items x 100

ating each level of performance.

Individual development plan Competency gaps

4.1 Signatures of the assessment committee:
(1) Signature: ...................................... Chairman of the Assessment Comm

(.............................................)
Date: .............................................

(2) Signature: .......................................... Assessment Committee Member
(..............................................)

Date: .............................................

(5) Signature: ........................................ Assessment Committee Member
(.............................................)

Date: .............................................

6

Development method Duration

mittee (3) Signature: .................................. Assessment Committee Member
(.............................................)

Date: ...........................................

(4) Signature: ................................... Assessment Committee Member
(............................................)

Date: ...........................................

4.2 Acknowledgment of the result of the performance behavior assessment

Signature: .......................................... Assessment recipient
(.................................................)

Date: ..................................................

Part 5 Assessment of the work achievements according to the performance
through university budget), type: supporting (80 points)

*** Download the form with Excel formulas from the Human Resources D

Workload according to the agreement Percentage Qu
proportion
1. Routine workload ...........Score (40-70 %) F
1.1 100 (less
1.2 64
2. Development workload …......Score (10-40 %) 20
2.1 16
2.2 80
(1) Total workload percentage
(2) Total score
3. Workload assigned by the section, ratio 20%
(16 points)
3.1 As announced by the section
3.1.1
3.1.2
(3) Total score for workload assigned by the section
(4) Summarized percentage work achievement score

7

e agreement of government official/ University staff/University staff (paid

Division’s website *** Score (Score Ratio x
Quality Level Score)
uantity and quality of work (the assessor can fill out
the scores according to the specified range) /100

Fair Fairly Good Good Very good Excellent
than 60) (60-69.99) (70-79.99) (80-89.99) (90-100)

(5.1) Certification of the work achievement performance appraisal
(1) Signature: ................................... Chairman of the Assessment Comm

(.............................................)
Date: .............................................

(2) Signature: .......................................... Assessment Committee Membe
(..............................................)

Date: .............................................

(5) Signature: ........................................ Assessment Committee Member
(.............................................)

Date: .............................................

(5.2) Acknowledgment of the result of the performance assessment

Signature: ......................................... Assessment recipient
(..............................................)

Date: .............................................

8

mittee (3) Signature: ................................. Assessment Committee Member
(.............................................)

Date: ...........................................

er (4) Signature: .................................. Assessment Committee Member
(............................................)

Date: ...........................................

r

Form PL.1: Agreement form and performance a
advancement for permanent emp

assessment form for personnel development and wage
ployees Prince of Songkla University

Agreement form and performance assessment form for p
for permanent employees Prince

Part 1 Personal information
1.1 Name of the assessment recipient: ……………………............. Departm

1.2 Annual assessment cycle year: ………...……onwards
(1) Permanent employee: [ ] first cycle, 1 June ………… - 30 Novem

[ ] second cycle, 1 December ………… - 31

1.3 Position: [ ] Administration

[ ] Operation Level: …
[ ] 1. Basic Service

[ ] 2. Support Staff Level:

[ ] 3. Technical Staff Level:

personnel development and wage advancement Form PL.1
e of Songkla University 24 May 2021

ment: ……………………… Faculty/Unit: …………………………………...

mber …………
1 May …………

………………………………………………….…
……………………………………………………
…………………………………………….………

Part 2 Work achievement agreement 100 % (20 Load units) and perfo

2.1 Work Achievement Agreement (Fill out at the beginning of each

assessment cycle)

Workload Goals/Achievements

1. Routine workload .........................%
1.1 ……………………………...…. %
1.2 ………………………………….%

2. Development workload ………......%
2.1 ……………………………...…. %
2.2 ………………………………….%

3. Workload assigned by section........%
3.1 …………………………………. %
3.2 …………………………………..%

I certify that statement 2.1 is true

Signature....................................... Assessment recipient
(……………………………….)

Signature.......................................Primary supervisor
(………………….…………….)

Remarks:

1. The workload is an agreement between the assessment recipien

2. In part 2, assessment recipients are asked to fill out Section 2.1
2.2 are to be completed prior to the end of the assessment cycle.

2

ormance reporting (to be filled out by the assessment recipient)

2.2 Reporting of the performance results according to the agreement. (Fill

out before the end of the assessment cycle)

Performance Result Document References/Data References

1. Routine workload

1.1 ……

1.2 ……

2. Development workload
2.1 ……….…..
2.2 ………..…

3. Workload assigned by section
3.1 ……….
3.2 ……….

I certify that statement 2.2 is true
and I have attached documents to support the assessment.

Signature.......................................... Assessment recipient
(.………………..…………)

Signature........................................Primary supervisor
(…………….…..…………)

nt and the primary supervisor for use in the performance appraisal.
1 prior to the beginning of the assessment. The performance results in Section

Part 3 Performance Information
3.1 Personal development information

3.1.1 Continue studies from the date:.............................................un
3.1.2 Attendance of seminar/academic meeting on the date: ............
3.1.3 Conduct research on the subject: .............................................
3.1.4 Study visit at: ...........................................................................
3.1.5 Work under the guidance and supervision on the topic: ..........
3.1.6 Brainstorm to develop a system of work on the topic: ...........
3.1.7 Other: .......................................................................................
3.2 Participation in quality assurance work/5S: ............................................
3.3 Self-improvement needs: ........................................................................
3.4 Suggestions for the unit: .........................................................................

3

ntil..................................................
...................................................................................................................
....................................................................................................................
...................................................................................................................
...................................................................................................................
....................................................................................................................
....................................................................................................................
...................................................................................................................
....................................................................................................................
....................................................................................................................

Part 4 Behavior assessment form, table 1 (20 points) ***download the for

Name: ............................................................. Position: .......................

Competency assessment score calculation table (Table 1)

Competencies (list of (A) Please provide an assessment score
competencies) (1-5 points)

P: Professionalism Chairman MC1 MC2 MC3 MC4 Cha
40

1. Accountability 0

2. Integrity 0

3. Agility 0

4. Innovation 0

5. Management 0

S: Social Responsibility

6. Customer-oriented 0

7. Value resource utilization 0

8. Volunteer spirit 0

U: Unity

9. Teamwork 0

Remarks 1. (a) Provide 1-5 scores, not more than 5 points per score. (b) Ratio of committees
proportion of committees’ scores changes according to the number of committees, i.e. 4 co

2. For the convenience of calculating and evaluating performance scores, it is best to use F

lPinakretd 4toPTeabrlfeo2r.mance Assessment Form Table 2 (20 points)

4

rm with Excel formulas from the Human Resources Division’s website***
....................................... Affiliation: .....................................................

(B) Assessment scores Assessment scores Competency
= (A)*proportion of each person
gaps
airman MC1 MC2 MC3 MC4 (E)=(C-3)
(A1) 15(A2) 15(A3) 15(A4) 15(A5)
(C) (D)
Percentage
Average
=a1+a2…

0.00 0.00 0.00 0.00 0.00 0.00 0.00 -3.00
0.00 0.00 0.00 0.00 0.00 0.00 0.00 -3.00
0.00 0.00 0.00 0.00 0.00 0.00 0.00 -3.00
0.00 0.00 0.00 0.00 0.00 0.00 0.00 -3.00
0.00 0.00 0.00 0.00 0.00 0.00 0.00 -3.00

0.00 0.00 0.00 0.00 0.00 0.00 0.00 -3.00
0.00 0.00 0.00 0.00 0.00 0.00 0.00 -3.00
0.00 0.00 0.00 0.00 0.00 0.00 0.00 -3.00

0.00 0.00 0.00 0.00 0.00 0.00 0.00 -3.00

s (Chairman + 3-5 committee, proportion of chairman’s score is always 40%, while the
ommittees = 15% each, 3 committees = 20% each, 2 committees = 30% each.

Form P.2, which is prepared in Excel. The calculations in Table 1 will be automatically

Part 4 Performance behavior assessment form, table 2 (20 points)
Name: .......................................................... Position: ................................

Competencies (1) Assessment resu

Level of assessment result Needs to be Below Meets
P: Professionalism
improved expectations expectation

Number of Number of Number of
Committee* Committee* Committee*

1. Accountability
2. Integrity
3. Agility
4. Innovation
5. Management
S: Social Responsibility
6. Customer Oriented
7. Value Resource Utilization
8. Volunteering Spirit
U: Unity
9. Teamwork

Remarks:
1. Summary of Performance Behavior Score = Total Assessm

___________

N
2. “Number of Committee” refers to the number of judges ra

5

................ Affiliation:..............................................

ults (2) Assessment scores Competency
gaps

Exceeds Average Percentage (5)
ns expectations Outstanding (3) (4)

f Number of Number of
* Committee* Committee*

ment Score x Weighted Value (20 points) = ……. x 20

____________________________ 900
Number of items x 100

ating each level of performance.

Individual development plan Competency gaps

4.1 Signatures of the assessment committee:
(1) Signature: ...................................... Chairman of the Assessment Comm

(.............................................)
Date: .............................................

(2) Signature: .......................................... Assessment Committee Member
(..............................................)

Date: .............................................

(5) Signature: ........................................ Assessment Committee Member
(.............................................)

Date: .............................................

6

Development method Duration

mittee (3) Signature: .................................. Assessment Committee Member
(.............................................)

Date: ...........................................

(4) Signature: ................................... Assessment Committee Member
(............................................)

Date: ...........................................

4.2 Acknowledgment of the result of the performance behavior assessment

Signature: .......................................... Assessment recipient
(.................................................)

Date: ..................................................

Part 5 Assessment of the work achievements according to the performance
through university budget), type: supporting (80 points)

*** Download the form with Excel formulas from the Human Resources D

Workload according to the agreement Percentage Qu
proportion
1. Routine workload ...........Score (40-70 %) F
1.1 100 (less
1.2 64
2. Development workload …......Score (10-40 %) 20
2.1 16
2.2 80
(1) Total workload percentage
(2) Total score
3. Workload assigned by the section, ratio 20%
(16 points)
3.1 As announced by the section
3.1.1
3.1.2
(3) Total score for workload assigned by the section
(4) Summarized percentage work achievement score

7

e agreement of government official/ University staff/University staff (paid

Division’s website *** Score (Score Ratio x
Quality Level Score)
uantity and quality of work (the assessor can fill out
the scores according to the specified range) /100

Fair Fairly Good Good Very good Excellent
than 60) (60-69.99) (70-79.99) (80-89.99) (90-100)

(5.1) Certification of the work achievement performance appraisal
(1) Signature: ................................... Chairman of the Assessment Comm

(.............................................)
Date: .............................................

(2) Signature: .......................................... Assessment Committee Membe
(..............................................)

Date: .............................................

(5) Signature: ........................................ Assessment Committee Member
(.............................................)

Date: .............................................

(5.2) Acknowledgment of the result of the performance assessment

Signature: ......................................... Assessment recipient
(..............................................)

Date: .............................................

8

mittee (3) Signature: ................................. Assessment Committee Member
(.............................................)

Date: ...........................................

er (4) Signature: .................................. Assessment Committee Member
(............................................)

Date: ...........................................

r

Welfare and benefits from P

Prince of Songkla University

Welfare and benefits fr

Welfare/benefits

1. Medical welfare
1.1 Ministry of Finance regulations
1.2 University staff fund
1.3 Social security
2. Welfare from Songklanagarind Hospital
2.1 Direct relatives to receive treatment according to universal healt
card and social security card
2.2 Cost deduction for excess room privileges: 50% for personnel 50
relatives
2.3 Staff has the right to receive preliminary treatment at the primary
first, and then be referred to medical specialists if needed
3. Savings promotion
3.1 Provident Fund for University Staff (PFUS)
3.2 Government Pension Fund (GPF)

3.3 Government Permanent Employee Registered Provident Fund (G

3.4 Prince of Songkla University Saving and Credit Cooperative Lim

4. Expense reduction
4.1 Agreement with a bank for low-interest mortgage loans
4.2 Agreement with the Golden Hill Village housing project
5. Accommodation
5.1 Accommodation for academic staff (support staff receives housi
in job description)
6. Honor and Recognition
6.1 Exemplary teachers and outstanding works

rom Prince of Songkla University

Govt official/ Eligible Personnel
Permanent
employee University employee
University staff (paid through

university budget)

✓ ✓
✓
✓

th insurance ✓✓ ✓
0%; 30% for ✓✓ ✓
y care clinic ✓✓ ✓

✓ ✓
✓ ✓

GPEF) ✓

mited ✓✓

✓✓ ✓

ing if specified ✓ ✓
✓ ✓

Welfare and benefits fr

Welfare/benefits

6.2 Selection of outstanding personnel and outstanding work among

6.3 Medal of honor for long government service
7. Education
7.1 Scholarships
7.2 Welfare loans for self-study
8. Education and child support

8.1 Tuition fee reimbursement according to Ministry of Finance reg

8.2 Reimbursement of tuition fees for children from the University

8.3 Loan for purchase of educational materials
8.4 Loan for children's tuition fees to cover excess costs
8.5 Early Childhood Center
8.6 PSU Wittayanusorn School, and Satit Wittaya School
9. Monetary compensation
10. Retirement
10.1 Retirement excursions
10.2 Recognition, and a golden statuette of His Royal Highness Prin
Songkhla
10.3 "Save PSU" Club membership
11. Welfare for deceased staff
11.1 cremation, and ceremonial accessories (not for permanent emp
11.2 Funeral allowance (max 300% of salary)
11.3 Funeral service: 20,000 baht per person
11.3 Loans for cultural activities (except auspicious events)

rom Prince of Songkla University

g support staff Govt official/ Eligible Personnel
Permanent University employee
employee
University staff (paid through
✓ university budget)

✓ ✓✓

✓ ✓✓
✓
✓
✓✓

gulations ✓ ✓ ✓
Staff Fund ✓
✓ ✓ ✓
nce Mahidol of ✓ ✓ ✓
ployees) ✓ ✓
✓ ✓ ✓
✓ ✓
✓ ✓
✓ ✓
✓ ✓
✓ ✓
✓ ✓
✓ ✓
✓
✓ ✓
✓
✓
✓

Welfare and benefits fr

Welfare/benefits

12. Ten types of loan benefits:
12.1 Loan for housing repairs: 100,000 baht
12.2 Loan for purchase or repair of vehicles: 50,000 baht
12.3 Loan for the purchase of computers and equipment in the amou
12.4 Loan for study visit abroad: 50,000 baht
12.5 Loan for cultural activities: 100,000 baht
12.6 Loan for children's tuition fees in excess of the right amount, ac
12.7 Self-educational loan, actual amount paid
12.8 Loan for the purchase of children's educational equipment: 5,00
12.9 Loan for medical treatment in the amount of 100,000 baht
12.10 Loan to buy life insurance: 50,000 baht
12.11 Loan for custom-tailored white government uniform with insig
12.12 Loan for custom-tailored gown: 10,000 baht

Faculties and units providing services and assistance:
1. Songklangarind Hospital, Faculty of Medicine
2. Dental Hospital, Faculty of Dentistry
3. Veterinary Medicine Hospital, Faculty of Veterinary Medicine
4. Thai Traditional Medicine Hospital, Faculty of Thai Traditional M

5. PSU Wittayanusorn School, Hat Yai, Surat Thani, Satit Pattani Sc
6. PSU Sports Complex
7. Early Childhood Development Department

rom Prince of Songkla University

Govt official/ Eligible Personnel
Permanent
employee University employee
University staff (paid through

university budget)

unt of 50,000 baht ✓ ✓ ✓
ctual amount paid ✓ ✓ ✓
00 baht ✓ ✓ ✓
gnia: 4,000 baht ✓ ✓ ✓
✓ ✓ ✓
✓ ✓ ✓
✓ ✓ ✓
✓ ✓ ✓
✓ ✓ ✓
✓ ✓ ✓
✓ ✓ ✓
✓ ✓ ✓

Medicine
chool

Welfare and benefits fr

Welfare/benefits

8. Prince of Songkla University Saving and Credit Cooperative Limi
9. Personnel Club, Lecturer Council, University Staff Council
10. Bank
11. Post office
12. PSU Agricultural Market
13. Food court and restaurant
14. Shop/Bookstore
15. Bangchak gas station
16. PSU Radio Broadcast Station
17. Self-study center, Faculty of Liberal Arts
18. Princess Maha Chakri Sirindhorn Natural History Museum
19. PSU Hall of History
20. Prince of Songkla University Service Cooperative Limited

rom Prince of Songkla University

Eligible Personnel

Govt official/ University employee
Permanent University staff (paid through
employee
university budget)

ited

870-201 CREATIVE TRANSMEDIA STORYTELLING

SAR Appendix

1