Others- 360 Degree Feedback Survey Sample #11

360 Feedback Survey

Instructions

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.

To what extent does [Participant Name] exhibit the following ...

SELECT the rating that best reflects the employee's performance in the areas listed.

Others

What does Others mean?
It means that ...

• You constructively receive criticism and suggestions from others.
• You work effectively with people from other departments.
• You consistently demonstrate ability and willingness to trust others.
• You support the efforts of other employees in implementing solutions to problems.
• You respect the opinions of other employees.

To what extent does this person exhibit Others?
Select from one of the ratings below.

Not Applicable or Unable to Judge

Poor does not perform to expected standards; often unable to complete tasks; does not seek help or advice

Minimal completes tasks only when pressured to do so; is satisfied with minimal progress; only does what is required

Average completes tasks easily; seeks to obtain maximal performance; willing to seek advice and help when needed

Role Model is a role model for others to follow; goes above and beyond what is expected; helps others

Commitment To Result

What does Commitment To Result mean?
It means that ...

• You create a sense of urgency among the store team members to complete activities, which drive sales.
• You are able to focus on a task even when working alone.
• You take immediate action toward goals.
• You encourage commitment in others to obtain results.
• You are willing to do whatever it takes-not afraid to have to put in extra effort.

To what extent does this person exhibit Commitment To Result?
Select from one of the ratings below.

Not Applicable or Unable to Judge

Poor does not perform to expected standards; often unable to complete tasks; does not seek help or advice

Minimal completes tasks only when pressured to do so; is satisfied with minimal progress; only does what is required

Average completes tasks easily; seeks to obtain maximal performance; willing to seek advice and help when needed

Role Model is a role model for others to follow; goes above and beyond what is expected; helps others

Self Management

What does Self Management mean?
It means that ...

• You step away from a situation to process appropriate response.
• You set an example for associates during stressful periods by maintaining a positive, can-do attitude.
• You do not allow own emotions to interfere with the performance of others.
• You deal with conflict by controlling own emotions by listening, being flexible, and sincere in responding.
• You consciously control own negative emotions in order to keep team morale up.

To what extent does this person exhibit Self Management?
Select from one of the ratings below.

Not Applicable or Unable to Judge

Poor does not perform to expected standards; often unable to complete tasks; does not seek help or advice

Minimal completes tasks only when pressured to do so; is satisfied with minimal progress; only does what is required

Average completes tasks easily; seeks to obtain maximal performance; willing to seek advice and help when needed

Role Model is a role model for others to follow; goes above and beyond what is expected; helps others

Fiscal Management

What does Fiscal Management mean?
It means that ...

• You keep excellent records for financial transparency.
• You monitor spending.
• You ensure others follow the correct rules and regulations on fiscal matters.
• You develop budgets and plans for various programs and initiatives.
• You effectively manage appropriations, reporting, purchases, expenditures, payrolls, and staff.

To what extent does this person exhibit Fiscal Management?
Select from one of the ratings below.

Not Applicable or Unable to Judge

Poor does not perform to expected standards; often unable to complete tasks; does not seek help or advice

Minimal completes tasks only when pressured to do so; is satisfied with minimal progress; only does what is required

Average completes tasks easily; seeks to obtain maximal performance; willing to seek advice and help when needed

Role Model is a role model for others to follow; goes above and beyond what is expected; helps others

Persuasion and Influence

What does Persuasion and Influence mean?
It means that ...

• You have excellent influencing/negotiating skills.
• You are able to express own goals and needs.
• You seek to obtain consensus or compromise.
• You develop a good rapport with others.
• You attempt to persuade others rather than simply control them.

To what extent does this person exhibit Persuasion and Influence?
Select from one of the ratings below.

Not Applicable or Unable to Judge

Poor does not perform to expected standards; often unable to complete tasks; does not seek help or advice

Minimal completes tasks only when pressured to do so; is satisfied with minimal progress; only does what is required

Average completes tasks easily; seeks to obtain maximal performance; willing to seek advice and help when needed

Role Model is a role model for others to follow; goes above and beyond what is expected; helps others

Strengths


Areas for Development


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