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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 maintain knowledge of current trends in the industry.
  1. You use a variety of problem-solving techniques to address issues facing the Company.
  1. You implement long-term solutions to problems.
  1. You anticipate business cycles and trends and makes adjustments in a timely manner.
  1. You formulate policies and strategies for addressing the Company's important challenges.
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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Competency
  1. You identify problems that need solved.
  1. You work hard toward the realization of goals.
  1. You risk your time, effort, and reputation toward the completion of goals.
  1. You are motivated to work toward the realization of goals.
  1. You understand the processes and various stages of business development.
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 engage in problem solving with individuals outside of the country.
  1. You understand how cultures differ and how these differences impact work behavior.
  1. You set the example for team on importance of cultural awareness.
  1. You consider customers point of view when making decisions.
  1. You can effectively deliver presentations to international clients.
Please feel free to provide any comments to help explain your answers?

Adaptability

Does Not
Exhibit this
Competency
Seldom
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Competency
Sometimes
Exhibits this
Competency
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Competency
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Competency
  1. You are flexible and adaptable when confronted with unexpected changes.
  1. You work effectively in dynamic and changing work environments.
  1. You are proactive and takes steps to prepare for changes in the workplace.
  1. You embrace changes in technology and automation.
  1. You are willing to change ideas or perceptions based on new information or contrary evidence which is presented.
Please feel free to provide any comments to help explain your answers?

Self Management

Does Not
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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 step away from a situation to process appropriate response.
  1. You deal with conflict by controlling own emotions by listening, being flexible, and sincere in responding.
  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.
  1. You do not allow own emotions to interfere with the performance of others.
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
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Exhibits this
Competency
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Exhibits this
Competency
  1. You stay calm, composed and positive during difficult events.
  1. You do not view setbacks as personal failures.
  1. You accurately perceive the emotions in yourself and others.
  1. You accurately perceive the emotional reactions of others.
  1. You help to make decisions and solve problems using knowledge about how others will react in certain situations.
Please feel free to provide any comments to help explain your answers?

Achievement

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
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Competency
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Competency
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Exhibits this
Competency
  1. You are driven to complete assignments on time.
  1. You accept setbacks and challenges as improvement opportunities
  1. You complete work promptly and efficiently.
  1. You establish stretch goals to advance skills and output.
  1. You are results oriented.
Please feel free to provide any comments to help explain your answers?

Objectives

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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Competency
  1. You communicate goals and objectives to employees.
  1. You set long-term and short-term goals.
  1. You consistently provide me with timely feedback for improving my performance.
  1. You are able to establish realistic goals.
  1. You effectively organize resources and plans
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 commit adequate resources toward safety measures.
  1. You participate in safety training when available.
  1. You ensure compliance with safety regulations.
  1. You support our company's safety programs.
  1. You keep accurate safety records.
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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Competency
  1. You recognize the abilities and skills of self and others
  1. You readily share credit and gives others opportunity for visibility.
  1. You offer recognition in a timely manner.
  1. You find opportunities to recognize others.
  1. You let employees know when they have done well
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.