Achievement - 360 Degree Feedback Survey Sample #7

360 Feedback Survey

Instructions

is administering a new web-based survey tool which is designed to gather broad feedback as it relates to core competencies and role responsibilities that are important for the on-going success of our organization. The Leadership Team Members have agreed to participate and are seeking your feedback.

In this regard, you have been selected to provide feedback for the manager listed above. Your feedback is an important part of 's leadership development process. This tool is intended to gather broad feedback in the core competencies and role responsibilities that are important for the on-going success of our organization.

In responding to the assessment form, please think about your experiences working with this individual during the last twelve (12) months. Your responses will be merged with other people's feedback and presented to guide them in their on-going development. Comments will be shared anonymously, as written, with the manager, unless you indicate otherwise.

You are only being asked to rate 8 competencies. Each competency will have a variety of statements that are grouped by 4 Performance Levels. Click on the level that best describes this individual.

Please ensure that your submission is made between .

Achievement	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
Increased revenue for the company.
Takes calculated risks to achieve difficult goals.
Holds others to high standards of achievement.
Driven to complete goals despite obstacles that may arise.
Allocates resources as needed to accomplish organizational goals.
If [Participant Name] were to make improvements in Achievement, what are your suggestions for how he/she can improve this?
Excellence	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
Takes a lot of pride in their work.
Demonstrates the analytical skills to do their job.
Can be counted on to add value wherever they are involved.
Demonstrates the functional or technical skills necessary to do their job.
Keeps themselves and others focused on constant improvement.
If [Participant Name] were to make improvements in Excellence, what are your suggestions for how he/she can improve this?
Trustworthy	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
Consistently keeps commitments.
Works in a way that makes others want to work with her/him.
Seeks to mitigate grievances by clarifying intentions and finding suitable remedies.
Is trustworthy; is someone I can trust.
Communicates an understanding of the other person's interests, needs and concerns.
If [Participant Name] were to make improvements in Trustworthy, what are your suggestions for how he/she can improve this?
Self Management	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
Is aware of personal impact on others and adjusts behavior to create a positive leadership presence.
Does not allow own emotions to interfere with the performance of others.
Analyzes own reactions on the spot to ensure that communication does not appear to be driven by anger.
Consciously controls own negative emotions in order to keep team morale up.
Sets an example for associates during stressful periods by maintaining a positive, can-do attitude.
If [Participant Name] were to make improvements in Self Management, what are your suggestions for how he/she can improve this?
Developing Others	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
Creates a work environment that fosters positive feedback to employees.
Develops employees by offering and encouraging them to take on new or additional responsibilities.
Recognizes and celebrates accomplishments of others.
Is open to receiving feedback.
Tries to ensure employees are ready to move to the next level.
If [Participant Name] were to make improvements in Developing Others, what are your suggestions for how he/she can improve this?
Fiscal Management	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
Ensures others follow the correct rules and regulations on fiscal matters.
Effectively manages appropriations, reporting, purchases, expenditures, payrolls, and staff.
Develops of the department's annual budget.
Monitors expenses and verifies the need for items purchased.
Develops budgets and plans for various programs and initiatives.
If [Participant Name] were to make improvements in Fiscal Management, what are your suggestions for how he/she can improve this?

31. Strengths
    
    
    
32. Areas for Development
    
    
    
33. Please give any final comments or suggestions for [Participant Name Here]'s assessment.