Excellence - 360 Degree Feedback Survey Sample #3

Instructions

You have been asked to evaluate yourself as part of a 360-degree feedback process. Other employees, including your manager(s), peers, and direct reports will also evaluate you. In this manner, you will be provided with a comprehensive, multi-perspective (i.e., 360-degree) view of your performance as a manager. The objective is to provide you with feedback so as to allow you to improve your performance, resulting in improved team performance, and organizational effectiveness.

If you are not able to respond to an item, leave it blank and go on to the next item.

We encourage everyone to complete the survey. Please be honest, constructive and thoughtful in your input. The survey is designed to help us understand more about your thoughts and needs to make a great company.

Please ensure that your submission is made between and . The survey will only be available during these dates.

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Excellence	Does Not Exhibit this Competency	Seldom Exhibits this Competency	Sometimes Exhibits this Competency	Usually Exhibits this Competency	Always Exhibits this Competency
Produces high quality work.
Takes a lot of pride in their work.
Keeps themselves and others focused on constant improvement.
Is planful and organized.
Demonstrates the functional or technical skills necessary to do their job.
Please feel free to provide any comments to help explain your answers?
Communication Skills	Does Not Exhibit this Competency	Seldom Exhibits this Competency	Sometimes Exhibits this Competency	Usually Exhibits this Competency	Always Exhibits this Competency
Chooses the communication medium (ie. email, voice mail, memo, project document) that reflects the needs of the content. (ie. urgency, confidentiality, content scope)
Listens to others' points of view with an open mind
Able to demonstrate persuasiveness in pursuit of objectives.
Has the confidence to communicate effectively to all levels (from CEO down) of the organization, external customers, suppliers, as well as the senior counsel of other companies.
Is an effective communicator
Please feel free to provide any comments to help explain your answers?
Integrity	Does Not Exhibit this Competency	Seldom Exhibits this Competency	Sometimes Exhibits this Competency	Usually Exhibits this Competency	Always Exhibits this Competency
Establishes relationships of trust, honesty, fairness, and integrity.
Fosters a high standard of ethics and integrity.
Protects the integrity and confidentiality of information
Follows tasks to completion.
Develops trust and confidence from others.
Please feel free to provide any comments to help explain your answers?
Passion To Learn	Does Not Exhibit this Competency	Seldom Exhibits this Competency	Sometimes Exhibits this Competency	Usually Exhibits this Competency	Always Exhibits this Competency
Constantly enhances product knowledge through experimentation and play.
Is motivated by the desire to be "the best".
Demonstrates through personal behavior the commitment to high standards of performance.
Critiques own performance and learns from experience as a source of continuous improvement.
Holds self and associates accountable for goal achievement.
Please feel free to provide any comments to help explain your answers?
Managing Risk	Does Not Exhibit this Competency	Seldom Exhibits this Competency	Sometimes Exhibits this Competency	Usually Exhibits this Competency	Always Exhibits this Competency
Bases decisions on patterns found in fluid/changing information.
Rewards innovative experiments to try new ideas.
Able to adapt quickly to changing situations.
Seeks to maintain the long-term viability of the Company.
Recognizes that small changes may snowball into major events.
Please feel free to provide any comments to help explain your answers?
Partnering/Networking	Does Not Exhibit this Competency	Seldom Exhibits this Competency	Sometimes Exhibits this Competency	Usually Exhibits this Competency	Always Exhibits this Competency
Creates value within the Company by building networks.
Seeks to reduce institutional roadblocks to information sharing.
Develops a sense of trust in subordinates so they can freely interact and share information with others.
Seeks an understanding of diverse functions within the Company.
Collaborates with others to accomplish goals and objectives.
Please feel free to provide any comments to help explain your answers?
Company	Does Not Exhibit this Competency	Seldom Exhibits this Competency	Sometimes Exhibits this Competency	Usually Exhibits this Competency	Always Exhibits this Competency
Attends [Company] gatherings and social events.
Understands how decisions impact other business units beyond their immediate department of work group.
Understands the "basics" as to how [Company] functions/operates.
Impresses upon others the important aspects of [Company].
Expresses loyalty and dedication to [Company] in interactions with others.
Please feel free to provide any comments to help explain your answers?
Global Perspective	Does Not Exhibit this Competency	Seldom Exhibits this Competency	Sometimes Exhibits this Competency	Usually Exhibits this Competency	Always Exhibits this Competency
Considers customers point of view when making decisions.
Can effectively deliver presentations to international clients.
Sets the example for team on importance of cultural awareness.
Develops both the cultural awareness and business skills to grow our business in all countries, and work effectively across borders with employees, customers, and shareowners.
Aligns personal vision with global strategies.
Please feel free to provide any comments to help explain your answers?

41. Overall, please rate the effectiveness of .
    

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

    
    
42. Strengths
    
    
    
43. Areas for Development
    
    
    
44. Please give any final comments or suggestions for 's assessment.