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
Sets a high standard for job performance.
Able to organize work.
Works effectively in the department.
Listens and responds to issues and problems
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
...takes personal responsibility for results.
Responsible for setting the vision of the department.
Holds herself / himself accountable to goals / objectives
Sets a good example
Works in a way that makes others want to work with her/him.
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
Includes others in the decision making process.
Gives employees the opportunity to make their own decisions at work.
Gives employees input into the decision making process.
Encourages employees to think outside the box.
Allows employees to organize their schedule to best accomplish the job.
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
Develops a sense of trust in subordinates so they can freely interact and share information with others.
Promotes the understanding of how the department affects the organization overall.
Supports a partnering/networking culture.
Supports and encourages relationships that are created by diverse team members.
Seeks an understanding of diverse functions within the Company.
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
Helps the team make good decisions even under conditions of uncertainty.
Helps the team bounce back from obstacles to progress.
Recognizes and respects the contributions and needs of each individual.
Contributes to and supports team decision-making process
Shares resources and information with 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
Works effectively with people from other departments.
...treats others with respect and dignity.
Consistently demonstrates ability and willingness to trust others.
Treats others with respect and dignity.
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
Attends [Company] gatherings and social events.
Follows existing procedures and processes.
Understands how decisions impact other business units beyond their immediate department of work group.
Impresses upon others the important aspects of [Company].
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.