Commitment to Result - 360 Degree Feedback Survey Sample #5

360-Degree Assessment Survey

Dear Employee:

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 Closing Comments section. Your responses will be compiled with feedback from others and presented to the recipient to help guide their ongoing development.

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Please ensure that your submission is made by .

Thank you for your participation in the survey.

Management Team

Commitment To Result	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Takes immediate action toward goals.
Committed to the team.
Conveys strong sense of own pride in Company to associates by creating a shared vision around sales and customer service.
Creates a sense of urgency among the store team members to complete activities, which drive sales.
Maintains persistence and dedication to achieving results.
Co-worker Development	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Gives others development opportunities through project assignments and increased job responsibilities
Provides ongoing feedback to co-workers on their development progress
Takes immediate action on poor performance
Sets and clearly communicates expectations, performance goals, and measurements to others
Adapts coaching and mentoring approach to meet the style or needs of individuals
Passion To Learn	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Holds self and associates accountable for goal achievement.
Takes initiative for own learning and development.
Actively seeks to learn by asking questions and listening to all store associates.
Is motivated by the desire to be "the best".
Critiques own performance and learns from experience as a source of continuous improvement.
Others	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Respects the opinions of other employees.
Able to see issues from others' perspectives.
Forms working relationships with employees from other departments.
Treats others with respect and dignity.
Works effectively with people from other departments.
Vision	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Works to support the strategy of [Company]
Demonstrates consistency between words and actions
Develops action plans to align his/her work with the goals of the organization
Clearly articulates a vision for his/her work and inspires others to support it
Communicates the vision and strategy of [Company]

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

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

    
    
27. Strengths
    
    
    
28. Areas for Development
    
    
    
29. Please give any final comments or suggestions for [Participant Name Here]'s assessment.