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)
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


Passion To Learn

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. You exhibit willingness to upgrade skills through additional training and education.
  1. You set achievable learning goals to develop new skills.
  1. You are willing to learn new procedures for working with the equipment.
  1. You seek to increase skill set.
  1. You demonstrate a willingness to participate in continuing education courses.
  1. You demonstrate through personal behavior the commitment to high standards of performance.
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 work to create innovative ideas from the collaboration with others.
  1. You allow various stakeholders to contribute their expertise in the decision making process.
  1. You share concerns and issues with others in the group.
  1. You meet with appropriate counterparts in negotiations as needed.
  1. You create an environment that encourages information sharing.
  1. You provide training and support for relationship building in the team.
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. I take time to recognize the efforts of others.
  1. You have empathy for coworkers.
  1. You assist those in the department who need help in meeting performance metrics.
  1. I demonstrate a high degree of ethics and integrity in the workplace.
  1. You demonstrate an understanding of other points of view.
  1. You communicate well at all levels of the organization.
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 encourage employees to solve problems on your own.
  1. You give employees autonomy to complete tasks on their own.
  1. You express confidence in the abilities of others.
  1. I view others in the department as valued assets to be trained and employed.
  1. I allow employees to take training to increase their skill levels so that they can be more independent.
  1. You give employees input into the decision making process.
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 are proactive and takes steps to prepare for changes in the workplace.
  1. You adapt to diversity within the team.
  1. You continually try to improve skills to remain current.
  1. You are open to changes in policies and procedures.
  1. You are able to adapt to changes in technology and processes.
  1. You will stop what you are doing to help colleagues in need.
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 ensure that assignments are prioritized according to the needs of the department/company.
  1. You consistently use a scheduler/planner.
  1. You organize tasks for the most efficient order of completion.
  1. You observe, analyze, and respond to merchandise needs while serving customers and accomplishing operational tasks.
  1. You are able to complete several tasks at the same time.
  1. You create, use and maintain "To-do" lists.
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 are proficient in the use of technical systems and processes.
  1. You identify gaps between actual and needed technical competencies and provide recommendations for required training.
  1. You adopt the implementation of new technology into the workplace.
  1. You support technical training and development of employees.
  1. You understand and are committed to implementing new technologies.
  1. You maximize the use of new technology to deliver products and services.
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 work effectively with people from other departments.
  1. You support the efforts of other employees in implementing solutions to problems.
  1. You constructively receive criticism and suggestions from others.
  1. You consistently demonstrate ability and willingness to trust others.
  1. You work across boundaries within the organization.
  1. You are able to see issues from others' perspectives.
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.