Performance - 360 Degree Feedback Survey Sample #7

360 Feedback Survey

Instructions

is administering a new web-based survey tool which is designed to gather broad feedback as it relates to core competencies and role responsibilities that are important for the on-going success of our organization. The Leadership Team Members have agreed to participate and are seeking your feedback.

In this regard, you have been selected to provide feedback for the manager listed above. Your feedback is an important part of 's leadership development process. This tool 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 assessment form, please think about your experiences working with this individual during the last twelve (12) months. Your responses will be merged with other people's feedback and presented to guide them in their on-going development. Comments will be shared anonymously, as written, with the manager, unless you indicate otherwise.

You are only being asked to rate 8 competencies. Each competency will have a variety of statements that are grouped by 4 Performance Levels. Click on the level that best describes this individual.

Please ensure that your submission is made between .

Performance	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
...Produce Quality
Listens and responds to issues and problems
Shown significant improvement in job performance.
...Overall Performance
Sets a high standard for job performance.
If [Participant Name] were to make improvements in Performance, what are your suggestions for how he/she can improve this?
Responsible	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
Sets a good example.
Holds herself / himself accountable to goals / objectives
...takes personal responsibility for results.
Works in a way that makes others want to work with her/him.
Is a person you can trust.
If [Participant Name] were to make improvements in Responsible, what are your suggestions for how he/she can improve this?
Empowering Others	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
Assigns important tasks to subordinates.
Listens to the ideas employees have for solving issues.
Gives employees the freedom to set their own schedule.
Permits employees to take training to become more independent.
Helps employees advance their skills so that they can have more autonomy.
If [Participant Name] were to make improvements in Empowering Others, what are your suggestions for how he/she can improve this?
Partnering/Networking	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
Invests in other companies to form equity partnerships.
Seeks opportunities to collaborate across organizational boundaries.
Engages with partners that offer complementary services and competencies.
Develops important industry contacts to facilitate business goals.
Seeks opportunities to meet with others.
If [Participant Name] were to make improvements in Partnering/Networking, what are your suggestions for how he/she can improve this?
Teamwork	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
Makes sure each team member participates in the task.
Facilitates effective decision-making practices to further develop the team.
Treats other team members with respect.
Makes decisions that support the team's goals and objectives.
Adjusts to changes in the composition of the team.
If [Participant Name] were to make improvements in Teamwork, what are your suggestions for how he/she can improve this?
Others	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
Respects the opinions of other employees.
Constructively receives criticism and suggestions from others.
Is able to see issues from others' perspectives.
Works effectively with people from other departments.
Able to see issues from others' perspectives.
If [Participant Name] were to make improvements in Others, what are your suggestions for how he/she can improve this?
Company	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
Attends [Company] gatherings and social events.
Follows existing procedures and processes.
Impresses upon others the important aspects of [Company].
Understands the use of [Company] products and services.
Expresses loyalty and dedication to [Company] in interactions with others.
If [Participant Name] were to make improvements in Company, what are your suggestions for how he/she can improve this?

36. Strengths
    
    
    
37. Areas for Development
    
    
    
38. Please give any final comments or suggestions for [Participant Name Here]'s assessment.