Trustworthy - 360 Degree Feedback Survey Sample #11

360 Feedback Survey

Questionnaires Measuring Trustworthiness:
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)

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 comment section for that competency. Your responses will be compiled with feedback from others and presented to the recipient to help guide their ongoing development.

Partially completed forms can be saved by using the Save/Still Working button at the bottom of the page. You may return at a later time to complete/edit the form. Your saved responses will be shown each time you re-visit the feedback form. When you are certain that you have completed your responses and will be not making any changes, click the Complete button.

To what extent does [Participant Name] exhibit the following ...

SELECT the rating that best reflects the employee's performance in the areas listed.


What does Trustworthy mean?
It means that ...
  • You deliver on promises made.
  • You take care to maintain confidential information.
  • You communicate an understanding of the other person's interests, needs and concerns.
  • You demonstrate a sense of responsibility and commitment to public trust.
  • You are a person others can count on.

To what extent does this person exhibit Trustworthy?
Select from one of the ratings below.

Passion To Learn

What does Passion To Learn mean?
It means that ...
  • You take advantage of training opportunities when they arise.
  • You stay up-to-date on emerging technologies.
  • You embrace new technology and procedures.
  • You demonstrate through personal behavior the commitment to high standards of performance.
  • You are committed to enhancing your own knowledge and skills.

To what extent does this person exhibit Passion To Learn?
Select from one of the ratings below.

Project Management

What does Project Management mean?
It means that ...
  • You develop action items, workplans, timelines, and criteria for projects.
  • You respond quickly and appropriately to unforeseen problems.
  • You maintain costs and expenses within budget limits.
  • You are able to adjust project schedule as needed to accommodate unforeseen issues.
  • You define project outcomes based on customer requirements.

To what extent does this person exhibit Project Management?
Select from one of the ratings below.


What does Technical mean?
It means that ...
  • You demonstrate mastery of the technical competencies required in your work.
  • You are knowledgeable of procedures or systems necessary for the job.
  • You willingly share your technical expertise; sought out as resource by others
  • You are naturally sought out by people outside your particular area for advice and opinion on a broad range of matters - not necessarily solely legal advice.
  • You keep current with technical advances within your professional discipline; embrace and apply new techniques and practices

To what extent does this person exhibit Technical?
Select from one of the ratings below.

Strategic Focus

What does Strategic Focus mean?
It means that ...
  • You create plans to develop and promote organizational and area strengths, as well as to address weaknesses.
  • You monitor performance of each market within the Area, utilizing reports to ensure sales growth, cost management, and profitability targets are met.
  • You look for opportunities to enhance contributions to the bottom line.
  • You focus attention on treating the causes of problems rather than simply addressing the symptoms.
  • You understand and contribute to development of strategic goals.

To what extent does this person exhibit Strategic Focus?
Select from one of the ratings below.

Areas for Development

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