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 demonstrate through personal behavior the commitment to high standards of performance.
  1. You are highly motivated to learn new skills.
  1. You are open to feedback from others.
  1. You demonstrate a willingness to participate in continuing education courses.
  1. You persist until goals are achieved and commitments are met.
  1. You desire to gain knowledge and enhance skills.
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 contribute expertise, insights, and resources to accelerate solutions to problems.
  1. You meet with appropriate counterparts in negotiations as needed.
  1. I build an environment of trust and respect to encourage risk-taking, innovation, and sharing of ideas.
  1. You are honest with others.
  1. You are willing to work with others to solve problems.
  1. I ensure all team members understand the goals.
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 keep commitments made with coworkers.
  1. I am willing to lend a hand to those in the department who need help.
  1. I value the input from coworkers.
  1. I am transparent and honest in communications, intentions, and actions.
  1. You are able to work with individuals at all levels of the company.
  1. I take time to recognize the efforts of 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. I assign tasks that allow employees to use their critical thinking skills.
  1. I coordinate the knowledge, skills and resources of others to accomplish more in the department.
  1. You provide opportunities for employee development and growth.
  1. You create opportunities for employees to exercise their independence.
  1. I acknowledge and appreciate employees for their proactive decision-making.
  1. You ensure employees understand what is being assigned to them.
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 can adjust tactics and strategies.
  1. You are able to adjust to changing environments.
  1. You adapt to changes in team membership.
  1. You work effectively in dynamic and changing work environments.
  1. You continually try to improve skills to remain current.
  1. You are able to adapt to new environments.
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 avoid bottlenecks in progress by assigning multiple individuals to critical tasks.
  1. You are able to complete several tasks at the same time.
  1. You delegate tasks to others when needed.
  1. You coordinate the work of a team by assigning tasks to other team members.
  1. You prioritize tasks for efficiency.
  1. You assess current capabilities before committing to new requests from customers.
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 apply complex rules and regulations to maintain optimal system performance.
  1. You understand and are committed to implementing new technologies.
  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 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 treat others with respect and dignity.
  1. You treat others with respect and dignity.
  1. You consistently demonstrate ability and willingness to trust others.
  1. You are able to see issues from others' perspectives.
  1. You support the efforts of other employees in implementing solutions to problems.
  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.