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 complete tasks on time in spite of delays in the process.
I create innovative products and services.
I move forward on important projects.
You are not afraid to take corrective action when necessary.
You motivate & supports others to gain skills
Performance	Definite Strength	Meets Standards	Needs Development	N/A
You are effective in performing your job.
You set a high standard for job performance.
You have great overall performance
You are able to organize work.
You shown significant improvement in job performance.
Flexibility	Definite Strength	Meets Standards	Needs Development	N/A
You are able to produce a wide range of products/services to meet demands.
I permit flexible working and flex-time to accommodate employee needs to meet external obligations.
I embrace change, values feedback, and is willing to experiment with different methods to find the most effective solutions.
You demonstrate flexibility in thoughts and actions.
I am flexible in my approach to dealing with unpredictable events.
Emotional Intelligence	Definite Strength	Meets Standards	Needs Development	N/A
You are able to express yourself clearly.
You are able to understand others' points of view.
You are able to manage your own emotions.
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.
Communication Skills	Definite Strength	Meets Standards	Needs Development	N/A
I face the person when speaking or listening to engage in direct communication.
I summarize the question to verify comprehension.
I adapt language and terminology to meet the needs of the audience.
You deliver effective presentations.
You deliver clear and concise instructions.
Persuasion and Influence	Definite Strength	Meets Standards	Needs Development	N/A
You persuade others to consider alternative points of view.
You are able to express own goals and needs.
You ensure stakeholders are involved in the decision making process.
You develop a good rapport with others.
You have excellent influencing/negotiating skills.
Goals	Definite Strength	Meets Standards	Needs Development	N/A
You make sure that team members have a clear idea of our group's goals.
You establish and document goals and objectives.
You achieve goals.
You set high expectations and goals; encourages others to support the organization.
You understand and contribute to development of strategic goals.
Technology Use/Management	Definite Strength	Meets Standards	Needs Development	N/A
You adopt the implementation of new technology into the workplace.
You support technical training and development of employees.
You identify gaps between actual and needed technical competencies and provide recommendations for required training.
You apply complex rules and regulations to maintain optimal system performance.
You use technology in decision making and problem solving.
Partnering/Networking	Definite Strength	Meets Standards	Needs Development	N/A
I attend industry conferences and seminars to meet new contacts and learn from industry leaders.
You develop key business relationships with clients/customers.
You leverage core competencies of partners to the benefit of both parties.
I actively prevent conflicts by identifying issues early and resolving them promptly.
You identify partnerships with overseas companies to expand market opportunities.
Teamwork	Definite Strength	Meets Standards	Needs Development	N/A
You act as an effective team player
I build a strong rapport with team members.
I facilitate good rapport between team members.
You foster teamwork rather than individual competition
I encourage other team members to adopt new procedures.

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.