Applicant name: _____________________________ Date interviewed: ____________

Position title: ________________________________ Position number: ____________

Department: ________________________________

Interviewer:__________________

5 - Excellent: Fully meets the competency requirements for the job.
4 - Very good: Meets most, but not all, of the competency requirements for the job.
3 - Adequate: Meets enough of the competency requirements to adequately perform the job.
2 - Marginal: Lacking in significant competency requirements.
1 - Poor: Grossly lacking in competency requirements.

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