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
Includes others in the decision making processes.
Constructively receives criticism and suggestions from others.
Helpful
Able to see issues from others' perspectives.
Is able to see issues from others' perspectives.
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
Is aware of cultural differences in business etiquette.
Facilitates team-building activities that celebrate diversity and foster mutual respect.
Functions effectively within various cultural contexts.
Actively listens to diverse viewpoints without judgment or dismissal.
Is responsive to individuals from other cultures.
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
Encourages employees to consider the merits of an unpopular change recently implemented.
Is viewed as authoritative, professional, and experienced.
Uses values-based language to inspire alignment and a shared sense of purpose among team members.
Strategically connects individual and team objectives to market trends.
Uses influence to shape thinking, not just actions - prompting reflection, reconsideration, or belief shifts.
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
Confronts unexpected changes by remaining flexible and adaptable.
Anticipates changes in the work environment.
Adjusts tactics when things are not working as expected.
Adjusts tactics and strategies.
Able to meet the needs of various stakeholders.
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.
Takes responsibility for seeing the project through to completion.
Lets supervisor know of any setbacks to the progress on achieving goals.
Holds team accountable to meeting goals.
Informs the supervisor if progress on the task has been delayed.
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 routines and visual cues to stay centered on task priorities.
Often works through lunches instead of going out for lunches.
Starts projects without delay.
Zeroes in on high-impact deliverables, bypassing low-value distractions.
Focuses time on the important tasks that add significant value.
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 technical training and development of employees.
Understands and is committed to implementing new technologies.
Maximizes the use of new technology to deliver products and services.
Proficient in the use of technical systems and processes.
Supports employee training and development initiatives regarding implementation of technology.
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
Develops a unified understanding or strategy that acknowledges and addresses the different viewpoints and resolves conflicts.
Maintains communication channels between parties in the negotiation.
Understands the other person's needs, concerns, and motivations.
Justifies viewpoints using strong and credible data.
A proficient conflict resolver who effectively navigates workplace disputes to maintain a harmonious and productive environment.
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.