Results Oriented - 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.

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Please ensure that your submission is made by .

Thank you for your participation in the survey.

Management Team

Results Oriented	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Stays focused on meeting the needs of customers.
Encourages a high-energy, fun work environment and coaches others on how to do the same
Demonstrates the personal confidence to "stay the course," even when faced with difficulty
Works toward achievement of goals even when confronted with obstacles.
Inspires and motivates co-workers to be productive and energetic at work
Objectives	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Communicates goals and objectives to employees.
Ability to establish realistic goals.
Works toward achieving established goals and objectives.
Establishes goals and objectives.
Assures [Company] principles are understood, employed & pursued.
Partnering/Networking	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Creates the conditions for partnerships to grow and develop.
Forges mutually beneficial relationships between individuals with diverse backgrounds.
Seeks an understanding of diverse functions within the Company.
Seeks to reduce institutional roadblocks to information sharing.
Supports and encourages relationships that are created by diverse team members.
Company	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Understands how decisions impact other business units beyond their immediate department of work group.
Expresses loyalty and dedication to [Company] in interactions with others.
Impresses upon others the important aspects of [Company].
Attends [Company] gatherings and social events.
Follows existing procedures and processes.
Planning	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Anticipates obstacles and ways to overcome them.
Works in an organized manner
Delegates role to team members to accomplish goals.
Able to identify the needs of the department before a major change.
Anticipates potential challenges, develops plan to overcome them and then carries out the plan.
Passion To Learn	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Holds self and associates accountable for goal achievement.
Is motivated by the desire to be "the best".
Persists until goals are achieved and commitments are met.
Constantly enhances product knowledge through experimentation and play.
Takes initiative for own learning and development.

31. Overall, please rate the effectiveness of .
    

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

    
    
32. Strengths
    
    
    
33. Areas for Development
    
    
    
34. Please give any final comments or suggestions for 's assessment.