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Strategic Insight- 360 Degree Feedback Survey Sample #3





Competencies Included:
Strategic Insight, Entrepreneurship, Global Perspective, Adaptability, Self Management, Emotional Intelligence, Achievement, Objectives, Safety, Recognition
Surveys Measuring Strategic Insight:
Survey 1 (4-point scale; Competency Comments)
Survey 2 (4-point scale; Competency Comments)
Survey 3 (5-point scale; Competency Comments)
Survey 4 (5-point scale; radio buttons)
Survey 5 (4-point scale; words)
Survey 6 (4-point scale; words)
Survey 7 (5-point scale; competency comments; N/A)
Survey 8 (3-point scale; Agree/Disagree words; N/A)
Survey 9 (3-point scale; Strength/Development; N/A)
Survey 10 (Comment boxes only)
Survey 11 (Single rating per competency)
Survey 12 (Slide-bar scale)
Self-Assessment Instructions

Leadership at [Company] are participating in a 360-Degree Feedback assessment. As part of this process, you need to complete a self-assessment questionnaire form. Other employees, including your manager(s), peers, and direct reports will also evaluate you.

Sample Result Document:
Sample Results
We encourage everyone to complete the survey. Please be honest, constructive and thoughtful in your input. The survey is designed to help us understand more about your thoughts and needs to make this a great company.

Please ensure that your submission is made between . The survey will only be available during these dates.




Strategic Insight

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. You use performance measures to gain insight into possible opportunities.
  1. You use a variety of problem-solving techniques to address issues facing the Company.
  1. You formulate policies and strategies for addressing the Company's important challenges.
  1. You implement long-term solutions to problems.
  1. You understand how to circumvent barriors to change within the organization.
Please feel free to provide any comments to help explain your answers?

Entrepreneurship

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
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Exhibits this
Competency
  1. You encourage dynamic growth opportunities.
  1. You seek and utilize mentors to help guide your professional development.
  1. You take the initiative to complete tasks.
  1. You believe in your vision for the department/organization.
  1. You maintain a high level of energy to respond to demands of the job.
Please feel free to provide any comments to help explain your answers?

Global Perspective

Does Not
Exhibit this
Competency
Seldom
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Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
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Exhibits this
Competency
  1. You apply knowledge of overseas markets.
  1. You attend training seminars and conferences to increase skills in working with others globally.
  1. You respect individual differences.
  1. You consider customers point of view when making decisions.
  1. You demonstrate a curiosity about diverse individuals and cultures.
Please feel free to provide any comments to help explain your answers?

Adaptability

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. You are able to adjusts tactics when things are not working as expected.
  1. You can adjust plans as needed based on changing conditions.
  1. You are able to adjust plans to meet new situations.
  1. You are able to adjust to the new vision and mission of the company.
  1. You are open to change and adjusts plans when needed.
Please feel free to provide any comments to help explain your answers?

Self Management

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. You do not allow own emotions to interfere with the performance of others.
  1. You are aware of personal impact on others and adjusts behavior to create a positive leadership presence.
  1. You consciously control own negative emotions in order to keep team morale up.
  1. You set an example for associates during stressful periods by maintaining a positive, can-do attitude.
  1. You analyze own reactions on the spot to ensure that communication does not appear to be driven by anger.
Please feel free to provide any comments to help explain your answers?

Emotional Intelligence

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. You help to make decisions and solve problems using knowledge about how others will react in certain situations.
  1. You are able to express yourself clearly.
  1. You are able to understand others' points of view.
  1. You stay calm, composed and positive during difficult events.
  1. You accurately perceive the emotions in yourself and others.
Please feel free to provide any comments to help explain your answers?

Achievement

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
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Exhibits this
Competency
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Exhibits this
Competency
  1. You strive to exceed standards of performance.
  1. You complete work promptly and efficiently.
  1. You eliminate bureaucratic barriers to streamline processes.
  1. You take reasonable risks to achieve desired results.
  1. You accept setbacks and challenges as improvement opportunities
Please feel free to provide any comments to help explain your answers?

Objectives

Does Not
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Competency
Seldom
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Competency
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Competency
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Competency
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Exhibits this
Competency
  1. You establish goals and objectives.
  1. You work toward achieving established goals and objectives.
  1. You encourage others to take on greater responsibility.
  1. You effectively organize resources and plans
  1. You consistently provide me with timely feedback for improving my performance.
Please feel free to provide any comments to help explain your answers?

Safety

Does Not
Exhibit this
Competency
Seldom
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Competency
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Exhibits this
Competency
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Competency
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Exhibits this
Competency
  1. You participate in safety training when available.
  1. You encourage others to attend safety training.
  1. You develop a culture of safety.
  1. You mitigate hazards and safety issues that arise.
  1. You are aware of osha safety guidelines.
Please feel free to provide any comments to help explain your answers?

Recognition

Does Not
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Competency
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Competency
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Competency
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Competency
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Exhibits this
Competency
  1. You say "thank you" to show appreciation for work of others.
  1. You compliment other people when they do good work
  1. You offer recognition in a timely manner.
  1. You readily share credit and gives others opportunity for visibility.
  1. You recognize individuals for a specific outstanding achievement.
Please feel free to provide any comments to help explain your answers?

  1. Overall, please rate the effectiveness of [Participant Name].






  2. Strengths


  3. Areas for Development


  4. Please give any final comments or suggestions for [Participant Name Here]'s assessment.