Initiative - 360 Degree Feedback Survey Sample #10

360 Feedback Survey

Questionnaires Measuring Initiative:
Survey 1 (4-point scale; Competency Comments)
Survey 2 (4-point scale; Competency Comments)
Survey 3 (5-point scale; Competency Comments)
Survey 4 (5-point scale; radio buttons)
Survey 5 (4-point scale; words)
Survey 6 (4-point scale; words)
Survey 7 (5-point scale; competency comments; N/A)
Survey 8 (3-point scale; Agree/Disagree words; N/A)
Survey 9 (3-point scale; Strength/Development; N/A)
Survey 10 (Comment boxes only)
Survey 11 (Single rating per competency)
Survey 12 (Slide-bar scale)

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 comment section for that competency. 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.


  • Coach others to foster an environment which can adapt quickly and willingly to rapid change.
  • Takes action without being asked.
  • Prepares for unexpected contingencies.
  • Takes decisive action to address problems, following up with relevant team members and coaching them on how to improve.
  • Goes above and beyond the stated goals.
If [Participant Name] were to make improvements in Initiative, what are your suggestions for how he/she can improve this?

Strategic Insight

  • Analyzes records and reports to obtain insight into potential issues and trends.
  • Anticipates business cycles and trends and makes adjustments in a timely manner.
  • Formulates policies and strategies for addressing the Company's important challenges.
  • Identifies root causes of problems.
  • Communicates vision for the department and company.
If [Participant Name] were to make improvements in Strategic Insight, what are your suggestions for how he/she can improve this?

Continual Learning

  • Builds on their strengths while addressing their weaknesses.
  • Seeks opportunities to grow in skills and knowledge.
  • Pursues learning that will enhance job performance.
  • Grasps new ideas, concepts, technical, or business knowledge.
  • Pursues self-improvement through continual learning.
If [Participant Name] were to make improvements in Continual Learning, what are your suggestions for how he/she can improve this?

Project Management

  • Works with customers and clients to assess their needs and define project parameters.
  • Organizes, plans, and directs resources to accomplish the goals and objectives.
  • Maintains costs and expenses within budget limits.
  • Inspires others to accomplish goals and objectives.
  • Able to adjust project schedule as needed to accommodate unforeseen issues.
If [Participant Name] were to make improvements in Project Management, what are your suggestions for how he/she can improve this?

Global Perspective

  • Aligns personal vision with global strategies.
  • Understands how cultures differ and how these differences impact work behavior.
  • Can effectively deliver presentations to international clients.
  • Sets the example for team on importance of cultural awareness.
  • Demonstrates working knowledge of global transactions.
If [Participant Name] were to make improvements in Global Perspective, what are your suggestions for how he/she can improve this?
Overall, please rate the effectiveness of [Participant Name Here].


Areas for Development

Please give any final comments or suggestions for [Participant Name Here]'s assessment.