Others- 360 Degree Feedback Survey Sample #7

360 Feedback Survey

Instructions

is 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 '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 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 .

Others	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
...treats others with respect and dignity.
Consistently demonstrates ability and willingness to trust others.
Respects the opinions of other employees.
Forms working relationships with employees from other departments.
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
Interacts effectively with people from different cultural backgrounds.
Is open and honest in communications with individuals from other cultures.
Helps other employees to become more culturally sensitive.
Is willing to include individuals with different cultural backgrounds on the team.
Recognizes individual and cultural differences.
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
Seeks to obtain consensus or compromise.
Attempts to persuade others rather than simply control them.
Has excellent influencing/negotiating skills.
Persuades others to consider alternative points of view.
Communicates effectively with others.
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 changes easily.
Is open to new ideas and innovations.
Adjusts plans and procedures.
Able to step in and help co-workers when needed.
Learns from personal experiences and/or mistakes.
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
Able to complete required tasks on time and delivered expected results.
Holds self and others accountable for meeting the deadline.
Can be counted on to do their role well.
Sets clear performance measures.
Consistently strives to meet high standards of excellence.
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
Uses agendas when chairing or facilitating meetings.
Is productive for the majority of time spent during the day.
Keeps accurate records of time spent on projects for proper billing.
Automates tedious or repetitive tasks.
Works at a quick pace to avoid getting behind in work.
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
Uses technology in decision making and problem solving.
Supports technical training and development of employees.
Applies complex rules and regulations to maintain optimal system performance.
Proficient in the use of technical systems and processes.
Adopts the implementation of new technology into the workplace.
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
Is aware of potential emotional triggers that could negatively impact the negotiations.
Creates a decisive, team-oriented environment; clarifies goals; and outlines a strategic agenda.
Knows the BATNA (Best Alternative to a Negotiated Agreement) and is prepared to walk away if core interests are not met.
Persuades the other party of the benefits of our proposals.
Effectively sets the tone and agenda, creates rapport, and builds momentum at the start of negotiations.
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.