Managing Performance - 360 Degree Feedback Survey Sample #5

360-Degree Assessment Survey

Dear Employee:

You are going to be participating in a 360-Degree assessment. As part of this process you will need to complete the self-assessment questionnaire form below.

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

Managing Performance	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You plan and set work expectations.
You acknowledge employee contributions that support the bottom line.
You present performance feedback in a clear and concise manner.
You address grievances sooner rather than later.
You continuously measures performance and provides feedback to employees regularly.
Achievement	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You take calculated risks.
You set challenging goals.
You are determined to complete tasks regardless of obstacles that may occur.
You set challenging goals for the department.
You are flexible in adjusting priorities to meet the demands of changing situations.
Clarity	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You clearly explains responsibilities to individuals.
You make sure employees understand why they were given certain assignments.
You provide a clear vision for the future.
You use appropriate grammar and tense in communications.
You make sure goals and objectives are clearly and thoroughly explained and understood.
Regulatory/Compliance	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You know who to contact at various regulatory agencies if needed.
You keep up-to-date with legislation affecting employees.
You understand the applicable regulations and laws that impact our business.
You ensure regulations are followed as required.
You are professional and courteous in interactions with auditors and regulators.
Entrepreneurship	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You seek and utilize mentors to help guide your professional development.
You devote a certain amount of time and effort to developing new business opportunities.
You exhibit determination and passion in completion of goals.
You are comfortable operating in an environment of uncertainty.
You find unique ways to go around barriers to success.
Planning	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You anticipate potential challenges, develops plan to overcome them and then carries out the plan.
You delegate role to team members to accomplish goals.
You work in an organized manner
You anticipate obstacles and ways to overcome them.
You make plans and follows through.
Global Perspective	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You have positive interactions with individuals from different cultures and backgrounds.
You form strong client relationships with international partners.
You set the example for team on importance of cultural awareness.
You can effectively deliver presentations to international clients.
You develop both the cultural awareness and business skills to grow our business in all countries, and work effectively across borders with employees, customers, and shareowners.

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

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

    
    
37. Strengths
    
    
    
38. Areas for Development
    
    
    
39. Please give any final comments or suggestions for [Participant Name Here]'s assessment.