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
Works well in this position.
Sets a high standard for job performance.
Works effectively in the department.
Shown significant improvement in job performance.
Effectively organizes resources and plans
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.
Responsible for setting the vision of the department.
Acts as a resource without removing individual responsibility.
...takes personal responsibility for results.
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
Enables employees to take on more challenging roles.
Acknowledges and appreciates employees for their proactive decision-making.
Demonstrates confidence in the abilities of subordinates.
Set clear goals for assignments.
Coordinates the knowledge, skills and resources of others to accomplish more in the department.
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
Builds alliances between departments and teams.
Strives to cultivate and maintain a partnership based on trust and commitment in relationships.
Effectively develops networks with colleagues that have shared interests.
Exchanges innovative ideas with a network of colleagues.
Finds common ground with a wide range of stakeholders.
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
Facilitates team discussions and problem-solving
Listens to the opinions of other team members.
Able to work closely other team members who are considered to be difficult to work with.
Shares credit for accomplishments with team members
Seeks and listens to other's contributions
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
Consistently demonstrates ability and willingness to trust others.
Supports the efforts of other employees in implementing solutions to problems.
Includes others in the decision making processes.
Able to see issues from others' perspectives.
Constructively receives criticism and suggestions from others.
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 the "basics" as to how [Company] functions/operates.
Impresses upon others the important aspects of [Company].
Expresses loyalty and dedication to [Company] in interactions with others.
Understands the use of [Company] products and services.
Understands how decisions impact other business units beyond their immediate department of work group.
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.