Achievement - 360 Degree Feedback Survey Sample #9

Questionnaires Measuring Achievement:
Survey 1 (4-point scale; Competency Comments)
Survey 2 (4-point scale; Competency Comments)
Survey 3 (5-point scale; Competency Comments)
Survey 4 (5-point scale; radio buttons)
Survey 5 (4-point scale; words)
Survey 6 (4-point scale; words)
Survey 7 (5-point scale; competency comments; N/A)
Survey 8 (3-point scale; Agree/Disagree words; N/A)
Survey 9 (3-point scale; Strength/Development; N/A)

Thank you for providing feedback for the recipient above. As you respond, please draw on your first-hand experience with this individual in the past 12 months. Rate each item using the scale shown. If you don't feel you have enough first-hand information to rate a certain item, please choose the Not Applicable option. Comments can be very helpful; at a minimum where you give a particularly high or low rating, please share your reasons in the comment section for that competency. Your responses will be compiled with feedback from others and presented to the recipient to help guide their ongoing development.

Partially completed forms can be saved by using the Save/Still Working button at the bottom of the page. You may return at a later time to complete/edit the form. Your saved responses will be shown each time you re-visit the feedback form. When you are certain that you have completed your responses and will be not making any changes, click the Complete button.


Definite Strength Meets Standards Needs Development N/A
  1. Accepts setbacks and challenges as improvement opportunities
  1. Completes work to a high technical standard
  1. Follows-up and takes action when goals are not met to ensure better results in the future.
  1. Schedules time for self and others to optimize high priority and long term actions. Monitors progress towards business goals.
  1. Set high standards in their performance

Communication Skills

Definite Strength Meets Standards Needs Development N/A
  1. Is an effective communicator
  1. Coaches others and provides feedback on the use of different oral communication styles for different audiences
  1. Checks for understanding throughout conversations or group presentations/discussions
  1. Able to deliver presentations.
  1. Has the confidence to communicate effectively to all levels (from CEO down) of the organization, external customers, suppliers, as well as the senior counsel of other companies.


Definite Strength Meets Standards Needs Development N/A
  1. Acts decisively in frequently changing and uncertain environment.
  1. Effective in incorporating new ideas.
  1. Implements changes as a result of having listened to employees
  1. Encourages others to adopt new procedures.
  1. Can handle changes without complaining.

Bias for Action

Definite Strength Meets Standards Needs Development N/A
  1. Identifies ways to simplify work processes and reduce cycle times
  1. Conveys a sense of urgency about addressing problems and opportunities
  1. Coach others to foster an environment which can adapt quickly and willingly to rapid change.
  1. Displays high energy and enthusiasm on consistent basis.
  1. Encourages risk taking and experimentation to improve performance

Emotional Intelligence

Definite Strength Meets Standards Needs Development N/A
  1. Is able to control their own emotions.
  1. Is able to express themselves clearly.
  1. Helps to make decisions and solve problems using knowledge about how others will react in certain situations.
  1. Helps employees to resolve conflicts, communicate clearly, and work together to solve problems.
  1. Able to understand others' points of view.

Administrative Skill

Definite Strength Meets Standards Needs Development N/A
  1. Able to develop, justify and present a budget.
  1. High attention to detail.
  1. Enthusiastic about taking on challenging projects.
  1. Implements and uses performance measures.
  1. Completes reports on-time.

Time Management

Definite Strength Meets Standards Needs Development N/A
  1. Deals effectively with interruptions.
  1. Avoids distractions in the workplace.
  1. Completes high-priority work within required timelines.
  1. Makes time for developing plans and schedules.
  1. Completes tasks ahead of schedule.


Definite Strength Meets Standards Needs Development N/A
  1. Works in a way that makes others want to work with her/him.
  1. Sets a good example
  1. Sets high personal standards of performance.
  1. ...takes personal responsibility for results.
  1. Holds herself / himself accountable to goals / objectives


Definite Strength Meets Standards Needs Development N/A
  1. Resolves difficult negotiations whether it is a contract, sub contract, legal or any other difficult negotiation fairly and reasonably.
  1. Influences others through rational argument and persuasion.
  1. Leverages relationships with others to achieve goals.
  1. Able to say "no" when necessary to effectively execute business strategy and meet long-term objectives.
  1. Able to say "no" when it is essential to maintaining quality and high standards.

Organizational Fluency

Definite Strength Meets Standards Needs Development N/A
  1. Able to use corporate politics to advance department objectives.
  1. Anticipates problems that may affect the department.
  1. Effective in communicating with others within the organization.
  1. Understands the current organizational culture.
  1. Adept at navigating within the culture of the department.

  1. Overall, please rate the effectiveness of .

  2. Strengths

  3. Areas for Development

  4. Please give any final comments or suggestions for 's assessment.