Initiative - 360 Degree Feedback Survey Sample #5

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.

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Please ensure that your submission is made by .

Thank you for your participation in the survey.

Management Team

Initiative	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Takes action without being asked.
Immediately works to complete goals well before their deadline.
Takes the initiative to change the direction or course of events.
Takes decisive action to address problems, following up with relevant team members and coaching them on how to improve.
Coach others to foster an environment which can adapt quickly and willingly to rapid change.
Change Management	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Adopts changes to set and example for others to follow.
Effective in dealing with ambiguous and challenging situations.
Supports the Company's efforts to implement changes.
Supports new initiatives for organizational changes to improve effectiveness.
Addresses organizational and departmental resistance to changes.
Developing Others	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Tries to ensure employees are ready to move to the next level.
Encourages employees through recognition of positive changes in behavior.
Recognizes and celebrates accomplishments of others.
Sets performance objectives for subordinates that encourages development opportunities.
Is open to receiving feedback.
Fiscal Management	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Monitors spending.
Effective in using Company's resources.
Develops budgets and plans for various programs and initiatives.
Keeps excellent records for financial transparency.
Provides budgeting and accounting support to the Company.
Vision	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Persuades others to follow the Company's vision.
Creates a positive vision of the future for the Company.
Understands the vision of the Company and promotes it ahead of any self-interests.
Expresses the Company vision in a way that is easily understood and adopted by employees.
Develops action plans to align his/her work with the goals of the organization

26. Overall, please rate the effectiveness of .
    

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

    
    
27. Strengths
    
    
    
28. Areas for Development
    
    
    
29. Please give any final comments or suggestions for 's assessment.