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 understand and contribute to development of strategic goals.
You set challenging stretch goals
You conduct timely follow-up; keeps others informed on a need to know basis.
You establish and document goals and objectives.
You set high expectations and goals; encourages others to support the organization.
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 inspire creativity in your team.
You add value to the department/organization.
You create a lot of new ideas.
You are creative and inspirational.
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 conduct appointments at scheduled start time.
You respond to requests for information in a timely manner.
You maintain an efficient schedule of activities.
You arrive to meetings on time.
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 express loyalty and dedication to [Company] in interactions with others.
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.
You follow existing procedures and processes.
You attend [Company] gatherings and social events.
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 volunteer for experiences and assignments abroad.
You demonstrate working knowledge of global transactions.
You exemplify the skills of a global worker.
You can effectively deliver presentations to international clients.
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.