Passion to Learn - 360 Degree Feedback Survey Sample #10

360 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)

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.

Passion To Learn

  • Is open minded and curious about learning new skills.
  • Demonstrates through personal behavior the commitment to high standards of performance.
  • Is open to feedback from others.
  • Holds self and associates accountable for goal achievement.
  • Recognizes own areas for development and consciously seeks assignments that will provide practice in areas of developmental need.
If [Participant Name] were to make improvements in Passion To Learn, what are your suggestions for how he/she can improve this?


  • Continually trying to improve skills to remain current.
  • Handles unexpected events without a loss of productivity.
  • Is aware of changes in the environment.
  • Adjusts priorities to the new Corporate mission.
  • Able to work effectively with new people and new teams.
If [Participant Name] were to make improvements in Adaptability, what are your suggestions for how he/she can improve this?

Commitment To Result

  • Coordinates all department activities into a cohesive team effort.
  • Takes immediate action toward goals.
  • Creates a sense of urgency among the store team members to complete activities, which drive sales.
  • Willing to do whatever it takes-not afraid to have to put in extra effort.
  • Maintains persistence and dedication to achieving results.
If [Participant Name] were to make improvements in Commitment To Result, what are your suggestions for how he/she can improve this?


  • Participates in safety training when offered.
  • Develops safety guidelines for the department.
  • Committed to safety in the workplace.
  • Is aware of OSHA safety guidelines.
  • Develops a culture of safety.
If [Participant Name] were to make improvements in Safety, what are your suggestions for how he/she can improve this?

Developing Others

  • Sets performance objectives for subordinates that encourages development opportunities.
  • Creates a work environment that fosters positive feedback to employees.
  • Is open to receiving feedback.
  • Recognizes and celebrates accomplishments of others.
  • Creates opportunities for professional development.
If [Participant Name] were to make improvements in Developing Others, what are your suggestions for how he/she can improve this?
Overall, please rate the effectiveness of [Participant Name Here].


Areas for Development

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