Objectives - 360 Degree Feedback Survey Sample #8

Questionnaires Measuring Objectives:
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)

You have been selected to provide feedback for the manager listed above. Your feedback is an important part of 's leadership development process. 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 six to twelve months. Your responses will be merged with other people's feedback and presented to to guide them in their on-going development. Comments will be shared anonymously, as written, with the manager.

Method of use: As part of the review process, managers will receive feedback from peers and staff. It is recognized that not all participants will be able to assess an individual's performance in all areas. The feedback received will be utilized as input to the manager's performance and on-going development plan.

You may sign out at any time by pressing the Save button at the end of the form and then closing your browser. You may return later to pick up where you left off. When you are done, press the Complete button.

When clicking your selection below, try to best fit the manager's actual behaviors to the scale provided.

If you are not sure, or unable to assess, select "Not Applicable" (N/A) option.

Please complete your response by .


Agree Unsure Disagree N/A
  1. Encourages me to take on greater responsibility.
  1. Establishes goals and objectives.
  1. Sets long-term and short-term goals.
  1. Organizes and schedules events, activities, and resources.
  1. Ability to establish realistic goals.


Agree Unsure Disagree N/A
  1. Makes a plan for getting things done and drives execution of the strategic plan, actively supporting or leading initiatives to closure.
  1. Schedules time for self and others to optimize high priority and long term actions. Monitors progress towards business goals.
  1. Set high standards in their performance
  1. Completes work to given time frame and to budget
  1. Follows-up and takes action when goals are not met to ensure better results in the future.

Establishing Focus/Direction

Agree Unsure Disagree N/A
  1. Stays focused even when under pressure and stress.
  1. Excellent at managing time.
  1. Maintains self-control when personally criticized.
  1. Sets appropriate goals for employees.
  1. Helps guide employees with prioritizing tasks.


Agree Unsure Disagree N/A
  1. Implements best practices within the department.
  1. Analyzes current procedures and identifies opportunities for improvement.
  1. Builds upon the ideas and solutions of others.
  1. Challenges current procedures to develop other alternatives.
  1. Offers constructive improvements to existing systems.

Interpersonal Skills

Agree Unsure Disagree N/A
  1. Strives for win/win solutions
  1. Provides constructive feedback in a way that fosters acceptance and development.
  1. Creates an atmosphere that supports the open expression of ideas
  1. Demonstrates willingness to work with others.
  1. Is a role model for others


Agree Unsure Disagree N/A
  1. Acts as a resource without removing individual responsibility.
  1. Works in a way that makes others want to work with her/him.
  1. Sets a good example.
  1. Is a person you can trust.
  1. Sets high personal standards of performance.


Agree Unsure Disagree N/A
  1. Coaches employees in how to strengthen knowledge and skills to improve work performance.
  1. Helps employees to understand responsibilities, authority, and expectations.
  1. Provides clear, motivating, and constructive feedback.
  1. Addresses employee behavior problems effectively.
  1. Conducts regular performance appraisals and feedback.


Agree Unsure Disagree N/A
  1. Works across boundaries within the organization.
  1. Forms working relationships with employees from other departments.
  1. Helpful
  1. Supports the efforts of other employees in implementing solutions to problems.
  1. Works effectively with people from other departments.

Cultural Awareness

Agree Unsure Disagree N/A
  1. Shows respect in daily interactions
  1. Maintains an inclusive work environment that maximizes the talents of others in achieving goals.
  1. Values the opinions of diverse groups and individual.
  1. Recognizes and values individual and cultural differences.
  1. Seeks out different viewpoints and benefits from different perspectives.

Global Perspective

Agree Unsure Disagree N/A
  1. Demonstrates working knowledge of global transactions.
  1. Sets the example for team on importance of cultural awareness.
  1. Aligns personal vision with global strategies.
  1. Can effectively deliver presentations to international clients.
  1. Develops both the cultural awareness and business skills to grow our business in all countries, and work effectively across borders with employees, customers, and shareowners.

  1. Overall, please rate the effectiveness of .

  2. Strengths

  3. Areas for Development

  4. Please give any final comments or suggestions for 's assessment.