Objectives - 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.

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

Objectives	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Consistently provides me with timely feedback for improving my performance.
Assures [Company] principles are understood, employed & pursued.
Organizes and schedules events, activities, and resources.
Effectively organizes resources and plans
Encourages me to take on greater responsibility.
Managing Performance	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Obtains commitment from employees regarding completion of tasks.
Sets and maintains high standards for self and others.
Provides employees with necessary resources to accomplish their goals.
Reviews job performance shortly after completion of tasks.
Prioritizes the work of others.
Analytical	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Can effectively interpret and analyze data.
Uses appropriate techniques to solve problems.
Actively seeks constructive feedback from others.
Asks the "right" questions to size up or evaluate situations.
Analyzes data and information from several sources and arrives at logical conclusions.
Problem Solving	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Works cooperatively with others to solve problems.
Is a good problem solver and decision maker
Effective in solving problems.
Identifies and assesses all potential responses to a problem.
Ability to develop innovative solutions to problems.
Technology Use/Management	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Applies complex rules and regulations to maintain optimal system performance.
Uses technology in decision making and problem solving.
Supports technical training and development of employees.
Supports employee training and development initiatives regarding implementation of technology.
Identifies gaps between actual and needed technical competencies and provides recommendations for required training.
Recognition	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Finds opportunities to recognize others.
Is sincerely interested in the suggestions of co-workers
Recognizes the abilities and skills of self and others
Recognizes team members who offer a significant contribution to a project.
Offers recognition in a timely manner.

31. Overall, please rate the effectiveness of .
    

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

    
    
32. Strengths
    
    
    
33. Areas for Development
    
    
    
34. Please give any final comments or suggestions for 's assessment.