Goals - 360 Degree Feedback Survey Sample #7

360 Feedback Survey

Self-Assessment Form Instructions

is administering a new web-based survey tool which is designed to gather broad feedback as it relates to core competencies and role responsibilities that are important for the on-going success of our organization. All Leadership Team Members will be participating at this time.

In this regard, you need to complete a self-assessment questionnaire form (below).
Your responses will be combined with the responses from your peers and direct reports. This tool is intended to gather broad feedback in the core competencies and role responsibilities that are important for the on-going success of our organization.

In responding to the assessment form, please think about your experiences working with this individual during the last twelve (12) months. Your responses will be merged with other people's feedback and presented to guide them in their on-going development. Comments will be shared anonymously, as written, with the manager, unless you indicate otherwise.

You are only being asked to rate 8 competencies. Each competency will have a variety of statements that are grouped by 4 Performance Levels. Click on the level that best describes this individual.

Please ensure that your submission is made between .

Goals	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
You make sure that team members have a clear idea of our group's goals.
You achieve established goals.
You set challenging stretch goals
You achieve goals.
You establish and document goals and objectives.
If you were to make improvements in Goals, what are your suggestions for how you can improve this?
Creativity	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
You add value to the department/organization.
You inspire creativity in your team.
You are creative and inspirational.
You create a lot of new ideas.
You are creative.
If you were to make improvements in Creativity, what are your suggestions for how you can improve this?
Punctuality	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
You invoice clients on a timely basis.
You avoid making personal phone calls during working hours.
You arrive to meetings on time.
You maintain an efficient schedule of activities.
You start the workday when scheduled.
If you were to make improvements in Punctuality, what are your suggestions for how you can improve this?
Company	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
You understand the use of [Company] products and services.
You attend [Company] gatherings and social events.
You follow existing procedures and processes.
You understand the "basics" as to how [Company] functions/operates.
You understand how decisions impact other business units beyond your immediate department of work group.
If you were to make improvements in Company, what are your suggestions for how you can improve this?
Global Perspective	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
You align personal vision with global strategies.
You are able to work with others from different cultures and countries.
You apply knowledge of overseas markets.
You engage in problem solving with individuals outside of the country.
You understand and appreciate the perspectives offered by others with different cultural backgrounds.
If you were to make improvements in Global Perspective, what are your suggestions for how you can improve this?

26. Strengths
    
    
    
27. Areas for Development
    
    
    
28. Please give any final comments or suggestions for [Participant Name Here]'s assessment.