Project Management - 360 Degree Feedback Survey Sample #7

360 Feedback Survey

Self-Assessment Form 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. All Leadership Team Members will be participating at this time.

In this regard, you need to complete a self-assessment questionnaire form (below).
Your responses will be combined with the responses from your peers and direct reports. 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 .

Project Management	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
You respond quickly and appropriately to unforeseen problems.
You organize, plan, and direct resources to accomplish the goals and objectives.
You organize work and sets priorities as needed.
You define project outcomes based on customer requirements.
You regularly review project performance and goals.
If you were to make improvements in Project Management, what are your suggestions for how you can improve this?
Objectives	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
You are able to organize work.
You effectively organize resources and plans
You organize and schedules events, activities, and resources.
You assure [Company] principles are understood, employed & pursued.
You are able to establish realistic goals.
If you were to make improvements in Objectives, what are your suggestions for how you can improve this?
Self Management	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
You use patience and self-control in working with customers and associates.
You are aware of personal impact on others and adjusts behavior to create a positive leadership presence.
You consciously control own negative emotions in order to keep team morale up.
You analyze interpersonal problems instead of reacting to them.
You step away from a situation to process appropriate response.
If you were to make improvements in Self Management, what are your suggestions for how you can improve this?
Feedback	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
You look to others for input.
You are easy to approach with ideas and opinions.
You are open to the suggestions of others.
You actively seek feedback from others.
You ask others for their ideas and opinions.
If you were to make improvements in Feedback, what are your suggestions for how you can improve this?
Responsible	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
You complete assigned work tasks.
Your behavior is ethical and honest.
You hold yourself accountable to goals / objectives
You set high personal standards of performance.
You set a good example.
If you were to make improvements in Responsible, what are your suggestions for how you can improve this?
Teamwork	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
You build consensus and share relevant information.
You encourage others to share ideas to develop team cohesion
You identify and resolves conflicts within the team to increase team effectiveness
You communicate a clear message that teamwork and collaboration are expected.
You seek and listen to other's contributions
If you were to make improvements in Teamwork, what are your suggestions for how you can improve this?
Strategic Insight	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
You maintain knowledge of current trends in the industry.
You anticipate business cycles and trends and makes adjustments in a timely manner.
You formulate strategies and action plans to ensure successful completion of goals and objectives.
You identify root causes of problems.
You identify potential problems before they become critical incidents.
If you were to make improvements in Strategic Insight, what are your suggestions for how you can improve this?

36. Strengths
    
    
    
37. Areas for Development
    
    
    
38. Please give any final comments or suggestions for [Participant Name Here]'s assessment.