Delegation - 360 Degree Feedback Survey Sample #11

360 Feedback Survey

Questionnaires Measuring Delegation:
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.

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.

To what extent does [Participant Name] exhibit the following ...

SELECT the rating that best reflects the employee's performance in the areas listed.


What does Delegation mean?
It means that ...
  • You entrust subordinates with important tasks.
  • You tell subordinates what to do, not how to do it.
  • You define the roles, responsibilities, required actions, and deadlines for team members.
  • You allow subordinates to use their own methods and procedures.
  • You assign tasks to create learning opportunities for the employees.

To what extent does this person exhibit Delegation?
Select from one of the ratings below.


What does Leadership mean?
It means that ...
  • You effectively lead others.
  • You clearly explain performance expectations and goals to be reached at the beginning of a project, then let others decide how to achieve the goal.
  • You are able to influence others.
  • You act decisively in implementing decisions.
  • You demonstrate leadership and courage in critical situations.

To what extent does this person exhibit Leadership?
Select from one of the ratings below.


What does Entrepreneurship mean?
It means that ...
  • You encourage dynamic growth opportunities.
  • You are excellent at managing relationships with stakeholders.
  • You devote a certain amount of time and effort to developing new business opportunities.
  • You encourage risk taking for developing potential business opportunities.
  • You are able to adapt the department to changing business demands and climate.

To what extent does this person exhibit Entrepreneurship?
Select from one of the ratings below.

Co-worker Development

What does Co-worker Development mean?
It means that ...
  • You work to identify root causes of performance problems
  • You give others development opportunities through project assignments and increased job responsibilities
  • You adapt coaching and mentoring approach to meet the style or needs of individuals
  • You set and clearly communicate expectations, performance goals, and measurements to others
  • You provide ongoing feedback to co-workers on your development progress

To what extent does this person exhibit Co-worker Development?
Select from one of the ratings below.

Passion To Learn

What does Passion To Learn mean?
It means that ...
  • You demonstrate through personal behavior the commitment to high standards of performance.
  • You take initiative for own learning and development.
  • You recognize own areas for development and consciously seek assignments that will provide practice in areas of developmental need.
  • You actively seek to learn by asking questions and listening to all store associates.
  • You are motivated by the desire to be "the best".

To what extent does this person exhibit Passion To Learn?
Select from one of the ratings below.

Areas for Development

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