Excellence - 360 Degree Feedback Survey Sample #5

360-Degree Assessment Survey

Dear Employee:

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 Closing Comments section. 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.

Please ensure that your submission is made by .

Thank you for your participation in the survey.

Management Team

Excellence	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Produces high quality work.
Is planful and organized.
Takes a lot of pride in their work.
Demonstrates the analytical skills to do their job.
Keeps themselves and others focused on constant improvement.
Punctuality	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Conducts appointments at scheduled start time.
Responds to requests for information in a timely manner.
Maintains an efficient schedule of activities.
Arrives to meetings on time.
Avoids making personal phone calls during working hours.
Time Management	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Maximizes time management by multitasking.
Uses a calendar effectively to keep track of when events or milestones are supposed to occur.
Uses scripts or software tools to automate computer centered processes.
Uses time efficiently to achieve higher productivity.
Gives undivided attention to tasks currently being worked on.
Commitment To Result	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Willing to do whatever it takes-not afraid to have to put in extra effort.
Maintains persistence and dedication to achieving results.
Able to focus on a task even when working alone.
Takes immediate action toward goals.
Conveys strong sense of own pride in Company to associates by creating a shared vision around sales and customer service.
Technology Use/Management	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Understands and is committed to implementing new technologies.
Applies complex rules and regulations to maintain optimal system performance.
Identifies gaps between actual and needed technical competencies and provides recommendations for required training.
Proficient in the use of technical systems and processes.
Adopts the implementation of new technology into the workplace.
Vision	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Skilled in developing and realizing a comprehensive organizational vision.
Develops a vision that is a catalyst for innovation and change.
Inspires individuals to achieve success by clearly communicating the organization's vision and motivating them to align their personal goals with this vision.
Shapes strategies that resonate with the department's shared vision.
Pinpoints specific challenges that the company faces and meticulously crafts tailored solutions to overcome these obstacles.

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

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

    
    
32. Strengths
    
    
    
33. Areas for Development
    
    
    
34. Please give any final comments or suggestions for [Participant Name Here]'s assessment.