Achievement - 360 Degree Feedback Survey Sample #11

360 Feedback Survey

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)
Survey 10 (Comment boxes only)
Survey 11 (Single rating per competency)
Survey 12 (Slide-bar scale)

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.

To what extent does [Participant Name] exhibit the following ...

SELECT the rating that best reflects the employee's performance in the areas listed.


What does Achievement mean?
It means that ...
  • You set high standards in your performance
  • You follow-up and take action when goals are not met to ensure better results in the future.
  • You complete work to given time frame and to budget
  • You complete work to a high technical standard
  • You demonstrate a well-organized and timely approach to achieve desired results

To what extent does this person exhibit Achievement?
Select from one of the ratings below.


What does Goals mean?
It means that ...
  • You make sure that team members have a clear idea of our group's goals.
  • You achieve goals.
  • You conduct timely follow-up; keeps others informed on a need to know basis.
  • You achieve established goals.
  • You establish and document goals and objectives.

To what extent does this person exhibit Goals?
Select from one of the ratings below.


What does Creativity mean?
It means that ...
  • You conceive, implement and evaluate ideas.
  • You add value to the department/organization.
  • You develop solutions to challenging problems.
  • You create a lot of new ideas.
  • You are creative.

To what extent does this person exhibit Creativity?
Select from one of the ratings below.

Supervisory Skills

What does Supervisory Skills mean?
It means that ...
  • You encourage employees to achieve your full potential.
  • You appropriately recognize and reward employees.
  • You promote teamwork and cooperation within the department.
  • You resolve personnel problems quickly and effectively.
  • You are aware of the unique strengths of each employee.

To what extent does this person exhibit Supervisory Skills?
Select from one of the ratings below.

Global Perspective

What does Global Perspective mean?
It means that ...
  • You analyze global issues/problems that are having a large impact on the Company.
  • You accept setbacks and challenges in foreign markets as improvement opportunities
  • You develop both the cultural awareness and business skills to grow our business in all countries, and work effectively across borders with employees, customers, and shareowners.
  • You form strong client relationships with international partners.
  • You set the example for team on importance of cultural awareness.

To what extent does this person exhibit Global Perspective?
Select from one of the ratings below.

Areas for Development

Please give any final comments or suggestions for [Participant Name Here]'s assessment.