Trustworthy - 360 Degree Feedback Survey Sample #7

360 Feedback Survey

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. The Leadership Team Members have agreed to participate and are seeking your feedback.

In this regard, you have been selected to provide feedback for the manager listed above. Your feedback is an important part of 's leadership development process. 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 .

Trustworthy	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
Is trustworthy; is someone I can trust.
Demonstrates a sense of responsibility and commitment to public trust.
Delivers on promises made.
Takes ownership, delivers on commitments
Is a person you can trust.
If [Participant Name] were to make improvements in Trustworthy, what are your suggestions for how he/she can improve this?
Passion To Learn	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
Exhibits willingness to upgrade skills through additional training and education.
Inspires others to learn new things.
Is open to feedback from others.
Takes advantage of training opportunities when they arise.
Embraces new technology and procedures.
If [Participant Name] were to make improvements in Passion To Learn, what are your suggestions for how he/she can improve this?
Attitude	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
Shows by their actions that they trust in the positive intentions of others.
Works to eliminate unnecessary work or barriers that get in others' way.
Treats all people fairly and with respect.
Builds open and trusting relationships.
Visibly supports and encourages diversity in style and background.
If [Participant Name] were to make improvements in Attitude, what are your suggestions for how he/she can improve this?
Emotional Intelligence	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
Able to understand others' points of view.
Is attentive to emotional cues and interprets others' feelings correctly.
Accurately perceives the emotional reactions of others.
Is able to control their own emotions.
Helps to make decisions and solve problems using knowledge about how others will react in certain situations.
If [Participant Name] were to make improvements in Emotional Intelligence, what are your suggestions for how he/she can improve this?
Innovation	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
Suggests new ideas at meetings.
Develops new products and services.
Encourages open communication to ensure that all proposals are considered.
Solves problems with insight and understanding.
Searches for opportunities and innovative ways to improve the organization.
If [Participant Name] were to make improvements in Innovation, what are your suggestions for how he/she can improve this?
Achievement	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
Schedules time for self and others to optimize high priority and long term actions. Monitors progress towards business goals.
Takes reasonable risks to achieve desired results.
Improved the quality of work on the production line.
Completes work promptly and efficiently.
Created impactful reports for the re-organization committee.
If [Participant Name] were to make improvements in Achievement, what are your suggestions for how he/she can improve this?
Objectives	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
Encourages me to take on greater responsibility.
Assures [Company] principles are understood, employed & pursued.
Sets long-term and short-term goals.
Able to organize work.
Consistently provides me with timely feedback for improving my performance.
If [Participant Name] were to make improvements in Objectives, what are your suggestions for how he/she can improve this?

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