Performance - 360 Degree Feedback Survey Sample #7

360 Feedback Survey

Instructions

We are requesting your participation in a 360-degree feedback review of several participants in our company's Leadership Development program. We are 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 this manager'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.

You will get the chance to evaluate this manager's performance in different areas and share your thoughts through written comments for more detailed feedback. Ensure that your feedback is constructive and helpful.

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
Effectively organizes resources and plans
Able to organize work.
...Produce Quality
Has great overall performance
Works well in this position.
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
Works in a way that makes others want to work with her/him.
...takes personal responsibility for results.
Completes assigned work tasks.
Sets high personal standards of performance.
Sets a good example
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
Set clear goals for assignments.
Views others in the department as valued assets to be trained and employed.
Recognizes the importance of a healthy work/life balance.
Encourages employees to take the initiative when responding to an issue.
Allows the employees to have flexible work schedules.
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
Creates strategic partnerships when resources are limited.
Develops networks with other companies to reduce costs and improve services.
Effectively develops networks with colleagues that have shared interests.
Maintains infrastructure to support partnerships and networks.
Promotes awareness of interests in partnerships and networks.
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
Coaches team members
Works with other team members to achieve objectives.
Demonstrates a willingness to work with the team.
Adjusts to changes in the composition of the team.
Supports open communication between team members.
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
Treats others with respect and dignity.
Forms working relationships with employees from other departments.
Able to see issues from others' perspectives.
Is able to see issues from others' perspectives.
...treats others with respect and dignity.
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
Understands how decisions impact other business units beyond their immediate department of work group.
Expresses loyalty and dedication to [Company] in interactions with others.
Understands the "basics" as to how [Company] functions/operates.
Follows existing procedures and processes.
Understands the use of [Company] products and services.
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.