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 respect the opinions of other employees.
• You work effectively with people from other departments.
• You consistently demonstrate ability and willingness to trust others.
• You form working relationships with employees from other departments.
• You are able to see issues from others' perspectives.

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 convey strong sense of own pride in Company to associates by creating a shared vision around sales and customer service.
• You are able to focus on a task even when working alone.
• You maintain persistence and dedication to achieving results.
• You coordinate all department activities into a cohesive team effort.
• You encourage commitment in others to obtain results.

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 use patience and self-control in working with customers and associates.
• You analyze interpersonal problems instead of reacting to them.
• You analyze own reactions on the spot to ensure that communication does not appear to be driven by anger.
• You do not allow own emotions to interfere with the performance of others.
• You step away from a situation to process appropriate response.

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 monitor expenses and verify the need for items purchased.
• You monitor spending.
• You provide budgeting and accounting support to the Company.
• You develop budgets and plans for various programs and initiatives.
• You keep excellent records for financial transparency.

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 communicate effectively with others.
• You ensure stakeholders are involved in the decision making process.
• You attempt to persuade others rather than simply control them.
• You are able to express own goals and needs.
• You understand what others need.

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.