Commitment to Result - 360 Degree Feedback Survey Sample #8

Self-Assessment Instructions

You have been selected to complete a self-assessment questionnaire as part of a 360-degree feedback assessment. Your feedback is an important part of 's leadership development process. This tool is intended to gather broad feedback in the core competencies and role responsibilities that are important for the on-going success of our organization.

Respond to the assessment form based on your work experiences during the previous 12 months. Your responses will be merged with other people's feedback and presented to you in your on-going development. Comments from others will be shared anonymously, as written.

Method of use: As part of the review process, managers will receive feedback from peers and staff. It is recognized that not all participants will be able to assess an individual's performance in all areas. The feedback received will be utilized as input to the manager's performance and on-going development plan.

You may sign out at any time by pressing the Save button at the end of the form and then closing your browser. You may return later to pick up where you left off. When you are done, press the Complete button.



Please complete your response by .

Commitment To Result	Agree	Unsure	Disagree	N/A
You are willing to do whatever it takes-not afraid to have to put in extra effort.
You encourage commitment in others to obtain results.
You maintain persistence and dedication to achieving results.
You coordinate all department activities into a cohesive team effort.
You take immediate action toward goals.
Establishing Focus/Direction	Agree	Unsure	Disagree	N/A
You stay focused even when under pressure and stress.
You help guide employees with prioritizing tasks.
You maintain focus when handling several problems or tasks simultaneously.
You are excellent at managing time.
You maintain self-control when personally criticized.
Strategic Focus	Agree	Unsure	Disagree	N/A
I identify and address strategic risks impacting operations.
I develops strategies to effectively use company resources and exploit potential opportunities.
You make decisions that yield more competitive advantages.
You create a mission statement describing the purpose for the organization.
You develop strategies to seek new opportunities.
Flexibility	Agree	Unsure	Disagree	N/A
You work effectively during periods of change.
I adapt processes and procedures in response to changes in the work environment.
I allow workflows to evolve with the employees' creativity.
I innovate skills and modify behaviors to remain flexible in addressing important issues.
You deliver a variety of products that vary in type and volume.
Passion To Learn	Agree	Unsure	Disagree	N/A
You inspire others to learn new things.
You embrace new technology and procedures.
You are open minded and curious about learning new skills.
You are open to feedback from others.
You will participate in training classes even if offered outside of normal working hours.
Cultural Awareness	Agree	Unsure	Disagree	N/A
You acknowledge your own biases in cultural interactions.
You hire individuals with different cultural backgrounds for the department.
You understand how implicit biases can affect decisions, communication and productivity.
I participate in cultural training sessions/classes.
You respect others regardless of age, race, gender, nationality, or disability.
Administrative Skill	Agree	Unsure	Disagree	N/A
You have strong technical/computer skills.
You are enthusiastic about taking on challenging projects.
You take responsibility for decisions.
You are able to develop, justify and present a budget.
You have strong organizational skills to keep the workspace and department in order
Innovation	Agree	Unsure	Disagree	N/A
You challenge current procedures to develop other alternatives.
You encourage open communication to ensure that all proposals are considered.
You suggest new ideas at meetings.
You search for opportunities and innovative ways to improve the organization.
You find creative ways to get things done with limited resources.
Objectives	Agree	Unsure	Disagree	N/A
You are able to establish realistic goals.
You assure [Company] principles are understood, employed & pursued.
You communicate goals and objectives to employees.
You organize and schedules events, activities, and resources.
You effectively organize resources and plans
Empowering Others	Agree	Unsure	Disagree	N/A
I value the input from others.
You recognize that employees may need flexibility in their working hours.
I allow employees to organize their schedule to best accomplish the job.
I encourage employees to expand their skills in order to take on greater responsibilities.
I consider ideas from employees that may challenge traditional ways of doing the job.
Partnering/Networking	Agree	Unsure	Disagree	N/A
I reinforce the contacts with other organizations.
I create joint initiatives or projects that serve the common interests of all parties.
You identify the right alliance partners with complementary and compatible services and resources.
You regularly schedule coffee chats or informal meetups to deepen personal connections.
I ensure that lessons learned from the partnership are disseminated and built upon.
Entrepreneurship	Agree	Unsure	Disagree	N/A
You seek and utilize mentors to help guide your professional development.
You take the initiative to complete tasks.
You have a strategic awareness on how to promote the organization.
You balance risks and rewards when making decisions.
You can work effectively in an environment of uncertainty.

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

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

    
    
62. Strengths
    
    
    
63. Areas for Development
    
    
    
64. Please give any final comments or suggestions for [Participant Name Here]'s assessment.