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 .

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Performance	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
Sets a high standard for job performance.
Listens and responds to issues and problems
Effective in performing his/her job.
Works well in this position.
Able to organize work.
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
Completes assigned work tasks.
Responsible for setting the vision of the department.
Holds herself / himself accountable to goals / objectives
Sets a good example
...takes personal responsibility for results.
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
Recognizes the accomplishments of employees when they complete important assignments.
Supports the decisions of others.
Gives employees the resources they need to complete the job.
Permits employees to take training to become more independent.
Assigns tasks that allow employees to use their critical thinking skills.
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
Leverages core competencies of partners to the benefit of both parties.
Engages in collaborative training sessions or workshops to build skills across organizations.
Partners with other organizations to develop new technologies and processes.
Implements effective oversight of network activities.
Optimizes processes by leveraging each function's strength.
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
Is committed to the success of the team.
Makes sure each team member participates in the task.
Actively participates in the work of teams; seeks and listens to others' contributions
Shows respect for other team members.
Lets team members know when they have done well.
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
Includes others in the decision making processes.
...treats others with respect and dignity.
Respects the opinions of other employees.
Consistently demonstrates ability and willingness to trust others.
Forms working relationships with employees from other departments.
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
Impresses upon others the important aspects of [Company].
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.