Action - 360 Degree Feedback Survey Sample #10

360 Feedback Survey

Instructions

We appreciate you taking the time to provide valuable feedback for the individual mentioned above. As you respond, please draw on your first-hand experience with this individual in the past 12 months. Your insights are crucial in offering a comprehensive evaluation. Please rate each item using the scale provided. If you find that you do not have sufficient first-hand knowledge to rate a particular item, select the Not Applicable option.

In addition to the ratings, we encourage you to include comments where possible. These comments are particularly useful when you give a very high or very low rating, as they provide context and clarity regarding your assessment. Explaining your reasons in the comment section helps ensure that your feedback is constructive and actionable.

Your responses, combined with feedback from other contributors, will be compiled and presented to the individual. This collective feedback aims to support their continuous growth and development by highlighting strengths and identifying areas for improvement. Your thoughtful participation is essential in helping them achieve their full potential.

You can save your progress on partially completed forms by clicking the Save/Still Working button located at the bottom of the page. This allows you to come back at a later time to finish or make any necessary edits to the form. When you return, your previously saved responses will automatically be displayed, allowing you to seamlessly continue where you left off. When you have completed filling out the form and are confident that no further changes are needed, please click the Complete button.

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Action

• Initiates projects or tasks that have a positive impact on the team.
• Takes charge without being asked.
• Takes responsibility for meeting performance standards.
• Delegates tasks and assignments to subordinates as soon as a request has been made.
• Ensures that the team's tasks align with its overall objectives.

If [Participant Name] were to make improvements in Action, what are your suggestions for how he/she can improve this?

Continual Learning

• Takes the initiative to learn new skills.
• Seeks opportunities to grow in skills and knowledge.
• Participates in regular training offered.
• Pursues self-improvement through continual learning.
• Improves on their skill sets.

If [Participant Name] were to make improvements in Continual Learning, what are your suggestions for how he/she can improve this?

Cultural Awareness

• Is curious and willing to ask questions about the cultural differences in the workplace.
• Effective in working with individuals with a variety of cultural backgrounds.
• Accepts individual differences.
• Seeks opportunities to learn about the other cultural backgrounds of colleagues.
• Acknowledges their own biases in cultural interactions.

If [Participant Name] were to make improvements in Cultural Awareness, what are your suggestions for how he/she can improve this?

Excellence

• Takes a lot of pride in their work.
• Demonstrates the functional or technical skills necessary to do their job.
• Produces high quality work.
• Is planful and organized.
• Demonstrates the analytical skills to do their job.

If [Participant Name] were to make improvements in Excellence, what are your suggestions for how he/she can improve this?

Trustworthy

• Demonstrates congruence between statements and actions.
• Is a person you can trust.
• Delivers on promises made.
• Consistently keeps commitments.
• Communicates an understanding of the other person's interests, needs and concerns.

If [Participant Name] were to make improvements in Trustworthy, what are your suggestions for how he/she can improve this?

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

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

Strengths


Areas for Development


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