Persuasion and Influence - 360 Degree Feedback Survey Sample #5

Dear Employee:

Thank you for providing feedback for the recipient above. As you respond, please draw on your first-hand experience with this individual in the past 12 months. Rate each item using the scale shown. If you don't feel you have enough first-hand information to rate a certain item, please choose the Not Applicable option. Comments can be very helpful; at a minimum where you give a particularly high or low rating, please share your reasons in the Closing Comments section. Your responses will be compiled with feedback from others and presented to the recipient to help guide their ongoing development.

Partially completed forms can be saved by using the Save/Still Working button at the bottom of the page. You may return at a later time to complete/edit the form. Your saved responses will be shown each time you re-visit the feedback form. When you are certain that you have completed your responses and will be not making any changes, click the Complete button.

Please ensure that your submission is made by .

Thank you for your participation in the survey.

Management Team

Persuasion and Influence	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Ensures stakeholders are involved in the decision making process.
Seeks to obtain consensus or compromise.
Attempts to persuade others rather than simply control them.
Has excellent influencing/negotiating skills.
Able to express own goals and needs.
Time Management	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Leaves time in the schedule for unplanned contingencies.
Keeps and maintains a To-Do list.
Completes tasks ahead of schedule.
Sets clearly defined goals.
Makes time for developing plans and schedules.
Change Management	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Effective in dealing with ambiguous and challenging situations.
Supports the Company's efforts to implement changes.
Supports new initiatives for organizational changes to improve effectiveness.
Assists others in understanding changes to the organization.
Works cooperatively with others to implement changes.
Client Focus	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Maintains strong relationships with clients.
Is pro-active in dealing with clients and addressing their needs.
Satisfies client needs.
Obtains feedback to ensure client needs are being met.
Looks for opportunities that have a positive impact on Clients.
Conflict Management	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Clearly expresses expectations to others.
Tries to understand others' point of view before making judgments
Deals effectively with employee grievances.
Assists team members by helping them see the other point of view.
Identifies and takes steps to prevent potential confrontations.
Others	Role Model	Capable and Effective	Somewhat Effective	Needs Development
...treats others with respect and dignity.
Forms working relationships with employees from other departments.
Is able to see issues from others' perspectives.
Works effectively with people from other departments.
Works across boundaries within the organization.
Cultural Awareness	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Seeks out different viewpoints and benefits from different perspectives.
Maintains an inclusive work environment that maximizes the talents of others in achieving goals.
Respects others regardless of age, race, gender, nationality, or disability.
Values the opinions of diverse groups and individual.
Shows respect in daily interactions
Fiscal Management	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Effectively manages appropriations, reporting, purchases, expenditures, payrolls, and staff.
Monitors spending.
Effective in using Company's resources.
Provides budgeting and accounting support to the Company.
Develops of the department's annual budget.
Global Perspective	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Sets the example for team on importance of cultural awareness.
Accepts setbacks and challenges in foreign markets as improvement opportunities
Understands how cultures differ and how these differences impact work behavior.
Analyzes global issues/problems that are having a large impact on the Company.
Forms strong client relationships with international partners.

46. Overall, please rate the effectiveness of .
    

    5- Very Effective 4- Effective 3- Neither 2- Ineffective 1- Very Ineffective

    
    
47. Strengths
    
    
    
48. Areas for Development
    
    
    
49. Please give any final comments or suggestions for 's assessment.