Commitment to Result - 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.

Commitment To Result	Definite Strength	Meets Standards	Needs Development	N/A
You maintain persistence and dedication to achieving results.
You are willing to do whatever it takes-not afraid to have to put in extra effort.
You are committed to the team.
You take immediate action toward goals.
You encourage commitment in others to obtain results.
Accountability	Definite Strength	Meets Standards	Needs Development	N/A
You define roles, rights, and responsibilities of the team.
You are someone who is trustworthy.
You are aware of problems or issues that may affect the organization.
You hold team accountable to meeting goals.
You take ownership of mistakes and learn from them.
Integrity	Definite Strength	Meets Standards	Needs Development	N/A
You foster a high standard of ethics and integrity.
You do what was promised.
You protect the integrity and confidentiality of information
You demonstrate sincerity in actions with others.
You establish relationships of trust, honesty, fairness, and integrity.
Professional Development	Definite Strength	Meets Standards	Needs Development	N/A
You are contributing fully to the extent of your skills
You keep yourself up-to-date of technical/professional issues
You encourage employees to take courses relevant to their job.
You quickly acquire and apply new knowledge and skills when needed
You demonstrate enthusiasm and a willingness to learn new skills and knowledge
Emotional Intelligence	Definite Strength	Meets Standards	Needs Development	N/A
You are attentive to emotional cues and interprets others' feelings correctly.
You accurately perceive the emotional reactions of others.
You help to make decisions and solve problems using knowledge about how others will react in certain situations.
You help employees to resolve conflicts, communicate clearly, and work together to solve problems.
You are able to control your own emotions.
Project Management	Definite Strength	Meets Standards	Needs Development	N/A
You work with customers and clients to assess your needs and define project parameters.
You inspire others to accomplish goals and objectives.
You respond quickly and appropriately to unforeseen problems.
You define project outcomes based on customer requirements.
You are able to adjust project schedule as needed to accommodate unforeseen issues.
Delegation	Definite Strength	Meets Standards	Needs Development	N/A
You entrust subordinates with important tasks.
You delegate tasks, responsibilities, and accountability as appropriate to the level of employee.
You clearly define duties and tasks to be completed.
You tell subordinates what to do, not how to do it.
You define the roles, responsibilities, required actions, and deadlines for team members.
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 set high expectations and goals; encourages others to support the organization.
You achieve established goals.
You conduct timely follow-up; keeps others informed on a need to know basis.
You establish and document goals and objectives.
Technology Use/Management	Definite Strength	Meets Standards	Needs Development	N/A
You adopt the implementation of new technology into the workplace.
You apply complex rules and regulations to maintain optimal system performance.
You support technical training and development of employees.
You use technology in decision making and problem solving.
You understand and are committed to implementing new technologies.
Safety	Definite Strength	Meets Standards	Needs Development	N/A
You seek to reduce the likelihood of accidents.
You perform work safely.
You create accurate and effective measures of safety.
You ensure compliance with safety regulations.
You support our company's safety programs.
Customer Focus	Definite Strength	Meets Standards	Needs Development	N/A
You ask questions and listen carefully to determine customer needs and to ensure that the customer's needs are met.
You develop good rapport and trust with the customer.
You consistently model positive customer service attitudes.
You develop strong customer relationships.
You maintain positive customer relationships.
Negotiation	Definite Strength	Meets Standards	Needs Development	N/A
You are able to decline bad ideas to avoid making poor decisions.
You change communication styles to meet the listener's needs.
You establish good working relationships with others.
You identify verbal and nonverbal cues to help interpret actions and messages.
You research the needs of the other party to identify strengths and weaknesses of positions.
Teamwork	Definite Strength	Meets Standards	Needs Development	N/A
You share credit for accomplishments with team members
You identify and resolves conflicts within the team to increase team effectiveness
You create a climate that encourages team participation.
You communicate a clear message that teamwork and collaboration are expected.
You work cooperatively with others to solve problems.
Vision	Definite Strength	Meets Standards	Needs Development	N/A
You behave in a way that is consistent with business values & code of conduct
You persuade others to follow the Company's vision.
You demonstrate consistency between words and actions
You communicate the vision and strategy of [Company]
You lead employees in new directions.

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

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

    
    
72. Strengths
    
    
    
73. Areas for Development
    
    
    
74. Please give any final comments or suggestions for [Participant Name Here]'s assessment.