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Passion to Learn - 360 Degree Feedback Survey Sample #1





360-Degree Feedback Survey

Questionnaires Measuring Passion to Learn:
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)
Survey 13 (4-point scale; numbers; floating anchors)
Survey 14 (4-point scale; N/A)
Instructions for Employees Participating in the 360-Feedback Assessment:

[Company] is conducting a 360-Degree Feedback Assessment developed by HR-Survey for selected managers.

You have been selected to receive feedback from a group of others. As part of this process, you will need to complete a self-assessment questionnaire at this time. Your feedback is an important part of our company's leadership development process and this survey 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 questions below, think about your experiences over the last 12 months. The effectiveness of this development tool is dependent on your honest, forthright and constructive responses so please bear this in mind as you answer each question. Your responses will be combined with the responses received from others and a report will be generated for you to foster growth and on-going 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.

Competencies Included:
Passion To Learn, Collaboration, Interpersonal Skills, Empowering Others, Adaptability, Juggling Multiple Responsibilities, Technology Use/Management, Others
Sample Result Document:
Sample Results
Your feedback is valuable in helping the individual to understand how they are perceived and experienced by others and the impact their behavior has on people in the organization with whom they interact. Feedback received also acknowledges strengths and identifies areas for development.

Use the form below to provide your feedback. Each field and comment box requires a response before you can SUBMIT your final feedback.

Please ensure that your submission is made between . The survey will only be available during these dates.

Thank you for your participation in the survey. We look forward to seeing the analysis of your responses and we are hoping for 100% participation.

Management Team
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Passion To Learn

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. You will participate in training classes even if offered outside of normal working hours.
  1. You hold self and associates accountable for goal achievement.
  1. You stay current with skills and training.
  1. You are committed to enhancing your own knowledge and skills.
  1. You take initiative for own learning and development.
  1. You enjoy learning new skills and techniques.
If you were to make improvements in Passion To Learn, what are your suggestions for how you can improve this?

Collaboration

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. You share information with others.
  1. I build an environment of trust and respect to encourage risk-taking, innovation, and sharing of ideas.
  1. I work with others to achieve common objectives.
  1. I create a culture that encourages understanding and valuing diverse perspectives to effectively resolve conflicts.
  1. I regularly seek feedback from employees on how to improve collaboration and act on their suggestions.
  1. You work with others to resolve issues facing the company.
If you were to make improvements in Collaboration, what are your suggestions for how you can improve this?

Interpersonal Skills

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. You are open to innovative ideas and suggestions from others
  1. You communicate initiatives in a clear and actionable manner to employees.
  1. You work cooperatively with others in the department.
  1. You give honest feedback and suggestions for improvement.
  1. You communicate well at all levels of the organization.
  1. You demonstrate willingness to work with others.
If you were to make improvements in Interpersonal Skills, what are your suggestions for how you can improve this?

Empowering Others

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. You give employees the opportunity to make their own decisions at work.
  1. I help employees advance their skills so that they can have more autonomy.
  1. I value the input from others.
  1. You express confidence in the abilities of others.
  1. I create a culture where employees are recognized and rewarded for taking the initiative and making impactful choices.
  1. You allow employees to make their own decisions.
If you were to make improvements in Empowering Others, what are your suggestions for how you can improve this?

Adaptability

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. You implement new rules, procedures, or regulations.
  1. I am willing to change priorities as need to reach consensus.
  1. You change to meet new priorities within the department/organization.
  1. You anticipate changes in the work environment.
  1. I adapt processes to meet the needs of new challenges.
  1. I learn new skills to stay competitive in the workplace.
If you were to make improvements in Adaptability, what are your suggestions for how you can improve this?

Juggling Multiple Responsibilities

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. You are able to complete several tasks at the same time.
  1. You organize tasks for the most efficient order of completion.
  1. You rank the importance of tasks to make sure critical tasks are completed first.
  1. You inform supervisor of the various tasks being worked on.
  1. You assign tasks based on skills of team members.
  1. You bounce back from daily crisis, disappointments and frustrations.
If you were to make improvements in Juggling Multiple Responsibilities, what are your suggestions for how you can improve this?

Technology Use/Management

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. You support technical training and development of employees.
  1. You support employee training and development initiatives regarding implementation of technology.
  1. You understand and are committed to implementing new technologies.
  1. You maximize the use of new technology to deliver products and services.
  1. You identify gaps between actual and needed technical competencies and provide recommendations for required training.
  1. You use technology in decision making and problem solving.
If you were to make improvements in Technology Use/Management, what are your suggestions for how you can improve this?

Others

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. You constructively receive criticism and suggestions from others.
  1. You treat others with respect and dignity.
  1. You form working relationships with employees from other departments.
  1. You include others in the decision making processes.
  1. You work across boundaries within the organization.
  1. You support the efforts of other employees in implementing solutions to problems.
If you were to make improvements in Others, what are your suggestions for how you can improve this?

  1. What are [Participant Name Here]'s greatest strengths demonstrated this year?


  2. What are [Participant Name Here]'s areas for development?


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