Cultural Awareness - 360 Degree Feedback Survey Sample #9

360 Feedback Survey

Questionnaires Measuring Cultural Awareness:
Survey 1 (4-point scale; Competency Comments)
Survey 2 (4-point scale; Competency Comments)
Survey 3 (5-point scale; Competency Comments)
Survey 4 (5-point scale; radio buttons)
Survey 5 (4-point scale; words)
Survey 6 (4-point scale; words)
Survey 7 (5-point scale; competency comments; N/A)
Survey 8 (3-point scale; Agree/Disagree words; N/A)
Survey 9 (3-point scale; Strength/Development; N/A)
Survey 10 (Comment boxes only)
Survey 11 (Single rating per competency)
Survey 12 (Slide-bar scale)

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 comment section for that competency. Your responses will be compiled with feedback from others and presented to the recipient to help guide their ongoing development.

Sample Result Document:
Sample Results
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.

Cultural Awareness

Definite Strength Meets Standards Needs Development N/A
  1. Seeks out different viewpoints and benefits from different perspectives.
  1. Respects others regardless of age, race, gender, nationality, or disability.
  1. Maintains an inclusive work environment that maximizes the talents of others in achieving goals.
  1. Fosters a diverse workforce free from discrimination and harassment.
  1. Treats others with dignity and respect.

Establishing Focus/Direction

Definite Strength Meets Standards Needs Development N/A
  1. Maintains focus when handling several problems or tasks simultaneously.
  1. Sets appropriate goals for employees.
  1. Makes sure that employees understand how their work relates to organizational goals.
  1. Stays focused even when under pressure and stress.
  1. Aligns the department's goals with the goals of the organization.


Definite Strength Meets Standards Needs Development N/A
  1. Develops goals and establishes objective measures of success.
  1. Defines roles, rights, and responsibilities of the team.
  1. Defines roles, rights, and responsibilities of employees.
  1. Can be counted on to do what they say they are going to do.
  1. Creates a consistent process for prioritizing work.

Continual Improvement

Definite Strength Meets Standards Needs Development N/A
  1. Analyzes processes to determine areas for improvement.
  1. Promotes training and development opportunities to enhance job performance.
  1. Looks for ways to improve work processes and procedures.
  1. Looks for ways to expand and learn new job skills.
  1. Encourages an employee culture of continuous improvement to seek out better ways of doing things.

Project Management

Definite Strength Meets Standards Needs Development N/A
  1. Organizes work and sets priorities as needed.
  1. Able to adjust project schedule as needed to accommodate unforeseen issues.
  1. Develops performance measures for various aspects of the project.
  1. Defines project outcomes based on customer requirements.
  1. Anticipates potential problems and institutes controls and contingency plans to address them.

Time Management

Definite Strength Meets Standards Needs Development N/A
  1. Completes tasks ahead of schedule.
  1. Keeps and maintains a To-Do list.
  1. Deals effectively with interruptions.
  1. Sets a good balance between work and family life.
  1. Completes high-priority work within required timelines.

Results Oriented

Definite Strength Meets Standards Needs Development N/A
  1. Directs team in prioritizing daily work activities
  1. Inspires and motivates co-workers to be productive and energetic at work
  1. Provides clear expectations for employees.
  1. Encourages a high-energy, fun work environment and coaches others on how to do the same
  1. Explains the "whys" behind organizational objectives


Definite Strength Meets Standards Needs Development N/A
  1. Seeks and listens to other's contributions
  1. Communicates a clear message that teamwork and collaboration are expected.
  1. Recognizes and respects the contributions and needs of each individual.
  1. Builds consensus and shares relevant information.
  1. Fosters respect and understanding among team members

Business Acumen

Definite Strength Meets Standards Needs Development N/A
  1. Applies the knowledge of work processes to influence the achievement of business goals
  1. Understands complex issues and problems.
  1. Able to align resources to meet the business needs of the company.
  1. Effectively develops and uses resources (people, time, money, supplies, equipment, and space) to improve organizational performance
  1. Asks the 'right' questions to size up or evaluate situations.


Definite Strength Meets Standards Needs Development N/A
  1. Communicates a vision of where the Company needs to be in the future.
  1. Understands the vision of the Company and promotes it ahead of any self-interests.
  1. Demonstrates consistency between words and actions
  1. Behaves in a way that is consistent with business values & code of conduct
  1. Persuades others to follow the Company's vision.

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

  2. Strengths

  3. Areas for Development

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