ML13083A050
| ML13083A050 | |
| Person / Time | |
|---|---|
| Issue date: | 12/03/2020 |
| From: | NRC/OCIO/GEMSD/IMSB |
| To: | |
| References | |
| Download: ML13083A050 (2) | |
Text
NRC FORM 212 (05-2017)
Name of applicant Position for which applied TO: (Name & title of supervisor or reference)
Applicant's position with your company Confirmed Dates of Employment Start Date End Date TECHNICAL AREA:
What were his/her strengths?
What were his/her weaknesses?
FROM:
Above Average Average Below Average Below Average Average Above Average Below Average Average Above Average How well did the applicant know the work?
How well did the applicant perform?
How well did the applicant manage the workload?
NRC FORM 212 (05-2017)
NRC MD 10.1 U. S. NUCLEAR REGULATORY COMMISSION QUALIFICATIONS INVESTIGATION PROFESSIONAL, TECHNICAL, AND ADMINISTRATIVE POSITIONS APPROVED BY OMB: NO. 3150-0033 EXPIRES: 04/30/2020 Estimated burden per response to comply with this mandatory collection request: 30 minutes. This information is used to determine the qualifications and suitability of external applicants for employment. Send comments regarding burden estimate to the Information Services Branch (T-2 F43), U.S. Nuclear Regulatory Commission, Washington, DC 20555-0001, or by e-mail to Infocollects.Resource@nrc.gov, and to the Desk Officer, Office of Information and Regulatory Affairs, NEOB-10202, (3150-0033), Office of Management and Budget, Washington, DC 20503. If a means used to impose an information collection does not display a currently valid OMB control number, the NRC may not conduct or sponsor, and a person is not required to respond to, the information collection.
The applicant named below has applied for a position in the NRC. Please rate the applicant in the items listed below with respect to the period of time you either supervised or were acquainted with the applicant. Include any comments you may feel are relevant. Please return the completed form to the Human Resources Specialist listed in the "FROM" block by the return date indicated, sealed in the enclosed envelope and marked For Addressee Only.
Human Resources Specialist Office of the Chief Human Capital Officer U. S. Nuclear Regulatory Commission Washington, DC 20555 Page 1
CHARACTERISTICS:
How would you describe the applicant's relationship with:
REQUIRED QUESTIONS:
Co-worker Supervisors Higher Level Officials Relationship to Applicant:
Supervisor Co-worker Professional Other (Specify)
NOTE: Consistent with the Privacy Act of 1974, this evaluation may be revealed to the applicant upon his or her request. However, if you request, your identity and other identifying information will be kept confidential.
My Identity May be Revealed I Request My Identity be Kept Confidential Typed Name and/or Title of Interviewer Signature of Interviewer Date Additional Comments NRC FORM 212 (05-2017)
Yes No No Yes No Yes Above Average Average Below Average Above Average Average Below Average Was the applicant dependable?
How did the applicant work in stressful situations?
- 1. Have you any reason to question this applicant's trustworthiness or loyalty to the U. S.?
- 2. Do you know of any personal habits or characteristics that would make this applicant unsuitable for employment by the U. S. Government?
- 3. Is this applicant eligible for re-hire in your organization?
NRC FORM 212 (05-2017)
NRC MD 10.1 U. S. NUCLEAR REGULATORY COMMISSION QUALIFICATIONS INVESTIGATION PROFESSIONAL, TECHNICAL, AND ADMINISTRATIVE POSITIONS (continued)
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