Achievement - 360 Degree Feedback Survey Sample #8

Self-Assessment Instructions

You have been selected to complete a self-assessment questionnaire as part of a 360-degree feedback assessment. 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.

Respond to the assessment form based on your work experiences during the previous 12 months. Your responses will be merged with other people's feedback and presented to you in your on-going development. Comments from others will be shared anonymously, as written.

Method of use: As part of the review process, managers will receive feedback from peers and staff. It is recognized that not all participants will be able to assess an individual's performance in all areas. The feedback received will be utilized as input to the manager's performance and on-going development plan.

You may sign out at any time by pressing the Save button at the end of the form and then closing your browser. You may return later to pick up where you left off. When you are done, press the Complete button.



Please complete your response by .

Achievement	Agree	Unsure	Disagree	N/A
You take calculated risks to achieve higher levels of performance.
I am highly motivated to achieve or exceed performance standards.
I am able to reduce department expenses by 25 percent.
You rapidly complete tasks and assignments.
I can complete required training and certification.
Results Oriented	Agree	Unsure	Disagree	N/A
I complete urgent tasks first.
I set objectives for the department.
You complete work on time.
I am motivated by a strong desire to exceed performance standards.
You achieve high levels of performance.
Excellence	Agree	Unsure	Disagree	N/A
You produce high quality work.
You demonstrate the analytical skills to do your job.
You demonstrate the functional or technical skills necessary to do your job.
You are planful and organized.
You take a lot of pride in your work.
Interpersonal Skills	Agree	Unsure	Disagree	N/A
I maintain a high degree of honesty and integrity.
You use knowledge and charisma rather than position, power, or coercion to influence others
I promote acceptance of diverse viewpoints from team members.
You believe honesty and integrity are core tenets of interpersonal relationships.
I am well respected in the department.
Passion To Learn	Agree	Unsure	Disagree	N/A
You demonstrate a willingness to participate in continuing education courses.
You are open to feedback from others.
You hold self and associates accountable for goal achievement.
You exhibit willingness to upgrade skills through additional training and education.
You demonstrate through personal behavior the commitment to high standards of performance.
Continual Improvement	Agree	Unsure	Disagree	N/A
You promote training and development opportunities to enhance job performance.
You search for new methods, techniques, and processes that increase efficiency and reduce costs.
You look for ways to expand and learn new job skills.
You look for ways to expand current job responsibilities.
You encourage an employee culture of continuous improvement to seek out better ways of doing things.
Management	Agree	Unsure	Disagree	N/A
You keep staff informed about what is happening in the company
You are ready to offer help
You delegate tasks effectively
You set an example for others to follow
You make others feel enthusiastic about your work
Persuasion and Influence	Agree	Unsure	Disagree	N/A
You seek to obtain consensus or compromise.
You communicate effectively with others.
You attempt to persuade others rather than simply control them.
You ensure stakeholders are involved in the decision making process.
You understand what others need.
Goals	Agree	Unsure	Disagree	N/A
You achieve goals.
You set high expectations and goals; encourages others to support the organization.
You make sure that team members have a clear idea of our group's goals.
You conduct timely follow-up; keeps others informed on a need to know basis.
You achieve established goals.
Customer Focus	Agree	Unsure	Disagree	N/A
You adapt to changing customer needs.
I am committed to the customer's success.
You effectively troubleshoot customer issues.
You promote, implement, maintain and enhances relationships with customers.
I exceed expectations of the customers.
Partnering/Networking	Agree	Unsure	Disagree	N/A
I develop important government contacts to ensure smooth business operations.
You understand the potential risks/rewards of the partnership.
You create opportunities and incentives for employees to learn and share knowledge with others.
I promote teamwork across departments, encouraging information exchange, and setting common goals.
I engage in collaborative training sessions or workshops to build skills across organizations.
Business Acumen	Agree	Unsure	Disagree	N/A
I assist others in better understanding the company's operations, goals, and strategic challenges.
I have an understanding of various asset classes and how to interpret balance sheets.
You anticipate the consequences to the business of different potential risk events.
You anticipate marketplace opportunities and supports speed to market.
You understand the costs, profits, markets, and added value of issues.
Strategic Insight	Agree	Unsure	Disagree	N/A
You develop a plan and strategy for each functional area within the mission statement.
You create a mission statement describing the purpose for the organization.
You anticipate business cycles and trends and make adjustments in a timely manner.
I attend industry conferences to gain further insight into how other companies deal with similar issues.
I observe employees at work to get better insight into the issues they are dealing with.
Planning	Agree	Unsure	Disagree	N/A
You set the appropriate sequence of tasks to efficiently achieve the goal.
I develop plans used to accomplish urgent or critical tasks.
I am open to input from others into the plan for development of the strategic plan.
I can develop a strategic plan to reduce costs in the department.
I determine the steps required for completion of a task.

71. Overall, please rate the effectiveness of [Participant Name Here].
    

    5- Very Effective 4- Effective 3- Neither 2- Ineffective 1- Very Ineffective

    
    
72. Strengths
    
    
    
73. Areas for Development
    
    
    
74. Please give any final comments or suggestions for [Participant Name Here]'s assessment.