Others- 360 Degree Feedback Survey Sample #9

360 Feedback Survey

Assessments Measuring Others:
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)
Survey 10 (Comment boxes only)
Survey 11 (Single rating per competency)
Survey 12 (Slide-bar scale)

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 comment section for that competency. 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.


Definite Strength Meets Standards Needs Development N/A
  1. Forms working relationships with employees from other departments.
  1. Helpful
  1. ...treats others with respect and dignity.
  1. Works effectively with people from other departments.
  1. Supports the efforts of other employees in implementing solutions to problems.

Administrative Skill

Definite Strength Meets Standards Needs Development N/A
  1. Takes responsibility for decisions.
  1. Has strong technical/computer skills.
  1. Completes reports on-time.
  1. Able to develop, justify and present a budget.
  1. Implements and uses performance measures.


Definite Strength Meets Standards Needs Development N/A
  1. Able to influence others.
  1. Clearly explains performance expectations and goals to be reached at the beginning of a project, then let's others decide how to achieve the goal.
  1. Acts decisively in implementing decisions.
  1. Effectively leads others.
  1. Demonstrates leadership and courage in critical situations.

Supervisory Skills

Definite Strength Meets Standards Needs Development N/A
  1. Treats all staff equitably.
  1. Delegates effectively.
  1. Maintains good working relationships with employees.
  1. Is aware of the unique strengths of each employee.
  1. Promotes teamwork and cooperation within the department.


Definite Strength Meets Standards Needs Development N/A
  1. Is creative.
  1. Inspires creativity in their team.
  1. Creates a lot of new ideas.
  1. Adds value to the department/organization.
  1. Develops solutions to challenging problems.

Passion To Learn

Definite Strength Meets Standards Needs Development N/A
  1. Critiques own performance and learns from experience as a source of continuous improvement.
  1. Is motivated by the desire to be "the best".
  1. Actively seeks to learn by asking questions and listening to all store associates.
  1. Persists until goals are achieved and commitments are met.
  1. Demonstrates through personal behavior the commitment to high standards of performance.

Juggling Multiple Responsibilities

Definite Strength Meets Standards Needs Development N/A
  1. Bounces back from daily crisis, disappointments and frustrations.
  1. Maintains self-confidence and a positive mental attitude while facing challenging peaks and valleys of activities.
  1. Recognizes and responds to product placement and signing needs while staying alert to customers' needs, store activities and training associates.
  1. Assesses current capabilities before committing to new requests from customers.
  1. Plans and organizes continuously while performing all other responsibilities and activities.


Definite Strength Meets Standards Needs Development N/A
  1. Communicates ideas and facts clearly and effectively in writing.
  1. Checks details thoroughly.
  1. Makes sure goals and objectives are clearly and thoroughly explained and understood.
  1. Maintains clarity in goals and objectives.
  1. Avoids creating ambiguity or mixed messages.


Definite Strength Meets Standards Needs Development N/A
  1. Takes ownership, delivers on commitments
  1. Demonstrates a sense of responsibility and commitment to public trust.
  1. Builds and maintains the trust of others.
  1. Demonstrates congruence between statements and actions.
  1. Consistently keeps commitments.


Definite Strength Meets Standards Needs Development N/A
  1. Capitalizes on partnerships and networks to enhance the Company's bottom line.
  1. Supports and encourages relationships that are created by diverse team members.
  1. Promotes the understanding of how the department affects the organization overall.
  1. Seeks an understanding of diverse functions within the Company.
  1. Creates the conditions for partnerships to grow and develop.

  1. Overall, please rate the effectiveness of [Participant Name Here].

  2. Strengths

  3. Areas for Development

  4. Please give any final comments or suggestions for [Participant Name Here]'s assessment.