Action - 360 Degree Feedback Survey Sample #9

360 Feedback Survey

Self-Assessment Instructions

Thank you for agreeing to participate in this leadership training process. As part of this process, you will be completing the self-assessment questionnaire (below). As you respond, please draw on your work experiences over the past 12 months. Rate each item using the scale shown. Comments at the end can help you to explain your ratings. If you gave 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 you at the next leadership seminar to help guide your ongoing professional 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.

Action	Definite Strength	Meets Standards	Needs Development	N/A
I take action in critical situations.
I overcome obstacles that may impede progress on a task.
I take responsibility for actions.
You work quickly to get the job done.
You delegate tasks and assignments to subordinates as soon as a request is made.
Performance	Definite Strength	Meets Standards	Needs Development	N/A
You shown significant improvement in job performance.
You work well in this position.
You have great overall performance
You listen and respond to issues and problems
You effectively organize resources and plans
Flexibility	Definite Strength	Meets Standards	Needs Development	N/A
You adapt to new organizational structures, policies, or procedures.
You are open to the perspectives/viewpoints of others.
You are open to alternative ways to accomplish goals
You are able to adapt to new situations.
You are effective in incorporating new ideas.
Emotional Intelligence	Definite Strength	Meets Standards	Needs Development	N/A
You help employees to resolve conflicts, communicate clearly, and work together to solve problems.
You are attentive to emotional cues and interprets others' feelings correctly.
You are able to control your own emotions.
You are able to manage your own emotions.
You are able to express yourself clearly.
Communication Skills	Definite Strength	Meets Standards	Needs Development	N/A
You communicate effectively with colleagues and customers
You deliver well-prepared, informed, poised and succinct presentations.
You have 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.
You ask follow-up questions as needed.
You are able to demonstrate persuasiveness in pursuit of objectives.
Persuasion and Influence	Definite Strength	Meets Standards	Needs Development	N/A
You attempt to persuade others rather than simply control them.
You communicate effectively with others.
You persuade others to consider alternative points of view.
You have excellent influencing/negotiating skills.
You ensure stakeholders are involved in the decision making process.
Goals	Definite Strength	Meets Standards	Needs Development	N/A
You establish and document goals and objectives.
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 set challenging stretch goals
You achieve established goals.
Technology Use/Management	Definite Strength	Meets Standards	Needs Development	N/A
You identify gaps between actual and needed technical competencies and provide recommendations for required training.
You are proficient in the use of technical systems and processes.
You maximize the use of new technology to deliver products and services.
You apply complex rules and regulations to maintain optimal system performance.
You support technical training and development of employees.
Partnering/Networking	Definite Strength	Meets Standards	Needs Development	N/A
You seek an understanding of diverse functions within the Company.
You create the conditions for partnerships to grow and develop.
You maintain infrastructure to support partnerships and networks.
You support a partnering/networking culture.
You capitalize on partnerships and networks to enhance the Company's bottom line.
Teamwork	Definite Strength	Meets Standards	Needs Development	N/A
You support open communication between team members.
You share resources and information with the team.
You actively participates as a team member
I help the team to bounce back from obstacles.
I build a strong rapport with team members.

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

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

    
    
52. Strengths
    
    
    
53. Areas for Development
    
    
    
54. Please give any final comments or suggestions for [Participant Name Here]'s assessment.