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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 exhibit willingness to upgrade skills through additional training and education.
  1. You enhance your value to the company through additional training and development.
  1. You demonstrate through personal behavior the commitment to high standards of performance.
  1. You desire to gain knowledge and enhance skills.
  1. You persist until goals are achieved and commitments are met.
  1. You constantly enhance product knowledge through experimentation and play.
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. I address interpersonal issues with a collaborative mindset.
  1. You encourage collaboration of fellow employees to achieve results.
  1. I give consideration to the innovative ideas presented by others.
  1. You display a high degree of trust and credibility.
  1. I share knowledge, ideas and resources to achieve quicker success.
  1. I effectively use technology to facilitate collaborative efforts in building process and policy documents.
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 show appreciation for other's work.
  1. You anticipate the concerns of other employees.
  1. You address critical customer issues in a timely manner.
  1. You give good advice and suggestions to coworkers.
  1. You are easily approachable.
  1. You are willing to communicate in person instead of through a mobile device.
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. I allow employees to take on more responsibilities.
  1. I enable employees to take on more challenging roles.
  1. You permit employees to take training to become more independent.
  1. I create a culture where employees are recognized and rewarded for taking the initiative and making impactful choices.
  1. I give new tasks to employees.
  1. You recognize the contributions that others make to the department.
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 able to recognize the potential benefits of change, and create an infrastructure which supports change.
  1. You are aware of changes in the environment.
  1. You are able to respond to incidents without stopping the workflow.
  1. You can adjust plans and procedures.
  1. You are flexible when dealing with changes.
  1. You adapt to diversity within the team.
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 recognize and respond to product placement and signing needs while staying alert to customers' needs, store activities and training associates.
  1. You are aware of the deadlines for specific tasks/assignments.
  1. You build in extra time in the schedule for unplanned events/occurrences.
  1. You complete multiple tasks simultaneously.
  1. You determine which tasks are critical and which tasks are optional.
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 apply complex rules and regulations to maintain optimal system performance.
  1. You adopt the implementation of new technology into the workplace.
  1. You support employee training and development initiatives regarding implementation of technology.
  1. You use technology in decision making and problem solving.
  1. You maximize the use of new technology to deliver products and services.
  1. You support technical training and development of employees.
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 form working relationships with employees from other departments.
  1. You are able to see issues from others' perspectives.
  1. You constructively receive criticism and suggestions from others.
  1. You include others in the decision making processes.
  1. You are able to see issues from others' perspectives.
  1. You work effectively with people from other departments.
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.