Others- 360 Degree Feedback Survey Sample #7

360 Feedback Survey

Instructions

We are requesting your participation in a 360-degree feedback review of several participants in our company's Leadership Development program. We are administering a new web-based survey tool which is designed to gather broad feedback as it relates to core competencies and role responsibilities that are important for the on-going success of our organization. The Leadership Team Members have agreed to participate and are seeking your feedback.

In this regard, you have been selected to provide feedback for the manager listed above. Your feedback is an important part of this manager'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.

You will get the chance to evaluate this manager's performance in different areas and share your thoughts through written comments for more detailed feedback. Ensure that your feedback is constructive and helpful.

In responding to the assessment form, please think about your experiences working with this individual during the last twelve (12) months. Your responses will be merged with other people's feedback and presented to guide them in their on-going development. Comments will be shared anonymously, as written, with the manager, unless you indicate otherwise.

You are only being asked to rate 8 competencies. Each competency will have a variety of statements that are grouped by 4 Performance Levels. Click on the level that best describes this individual.

Please ensure that your submission is made between .

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Others	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
...treats others with respect and dignity.
Includes others in the decision making processes.
Is able to see issues from others' perspectives.
Respects the opinions of other employees.
Supports the efforts of other employees in implementing solutions to problems.
If [Participant Name] were to make improvements in Others, what are your suggestions for how he/she can improve this?
Cultural Awareness	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
Understands the impact that our culture may have on interactions between individuals.
Functions effectively within various cultural contexts.
Seeks clarification to avoid misunderstandings.
Respects others regardless of age, race, gender, nationality, or disability.
Is aware of the similarities and differences among and between cultural groups.
If [Participant Name] were to make improvements in Cultural Awareness, what are your suggestions for how he/she can improve this?
Persuasion and Influence	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
Has excellent influencing/negotiating skills.
Able to express own goals and needs.
Communicates effectively with others.
Attempts to persuade others rather than simply control them.
Ensures stakeholders are involved in the decision making process.
If [Participant Name] were to make improvements in Persuasion and Influence, what are your suggestions for how he/she can improve this?
Adaptability	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
Handles unexpected events without a loss of productivity.
Adjusts priorities to changing business goals.
Is proactive and takes steps to prepare for changes in the workplace.
Adjusts priorities to the new Corporate mission.
Adapts to changes in team membership.
If [Participant Name] were to make improvements in Adaptability, what are your suggestions for how he/she can improve this?
Accountability	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
Sets clear expectations for performance.
Accepts the consequences for their actions.
Recognizes when a mistake is made and works to correct the issue.
Accepts accountability for their work.
Always starts work on time.
If [Participant Name] were to make improvements in Accountability, what are your suggestions for how he/she can improve this?
Time Management	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
Sustains high productivity levels throughout the day.
Excellent at keeping track of time.
Avoids delays by working quickly.
Able to keep to the project schedule.
Encourages coworkers to work productively.
If [Participant Name] were to make improvements in Time Management, what are your suggestions for how he/she can improve this?
Technology Use/Management	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
Supports employee training and development initiatives regarding implementation of technology.
Adopts the implementation of new technology into the workplace.
Uses technology in decision making and problem solving.
Proficient in the use of technical systems and processes.
Maximizes the use of new technology to deliver products and services.
If [Participant Name] were to make improvements in Technology Use/Management, what are your suggestions for how he/she can improve this?
Negotiation	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
A proficient conflict resolver who effectively navigates workplace disputes to maintain a harmonious and productive environment.
Adapts strategies to better meet the needs of the moment.
Maintains good interpersonal relationships with representatives from the other party.
Takes steps to control emotional responses to avoid making rash decisions.
Keeps emotions in check to avoid negative outbursts.
If [Participant Name] were to make improvements in Negotiation, what are your suggestions for how he/she can improve this?

41. Strengths
    
    
    
42. Areas for Development
    
    
    
43. Please give any final comments or suggestions for [Participant Name Here]'s assessment.