Vision- 360 Degree Feedback Survey Sample #11

360 Feedback Survey

Instructions

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.

Vision

What does Vision mean?
It means that ...

• You lead employees in new directions.
• You communicate a vision of where the Company needs to be in the future.
• You develop action plans to align your work with the goals of the organization
• You demonstrate consistency between words and actions
• You clearly articulate a vision for your work and inspires others to support it

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

Not Applicable or Unable to Judge

Poor does not perform to expected standards; often unable to complete tasks; does not seek help or advice

Minimal completes tasks only when pressured to do so; is satisfied with minimal progress; only does what is required

Average completes tasks easily; seeks to obtain maximal performance; willing to seek advice and help when needed

Role Model is a role model for others to follow; goes above and beyond what is expected; helps others

Cultural Awareness

What does Cultural Awareness mean?
It means that ...

• You value the opinions of diverse groups and individual.
• You treat others with dignity and respect.
• You foster a diverse workforce free from discrimination and harassment.
• You seek out different viewpoints and benefits from different perspectives.
• You recognize and value individual and cultural differences.

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

Not Applicable or Unable to Judge

Poor does not perform to expected standards; often unable to complete tasks; does not seek help or advice

Minimal completes tasks only when pressured to do so; is satisfied with minimal progress; only does what is required

Average completes tasks easily; seeks to obtain maximal performance; willing to seek advice and help when needed

Role Model is a role model for others to follow; goes above and beyond what is expected; helps others

Delegation

What does Delegation mean?
It means that ...

• You define goals and objectives for subordinates.
• You tell subordinates what to do, not how to do it.
• You assign tasks to create learning opportunities for the employees.
• You clearly define duties and tasks to be completed.
• You set clear and reasonable expectations for others and follows through on your progress.

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

Not Applicable or Unable to Judge

Poor does not perform to expected standards; often unable to complete tasks; does not seek help or advice

Minimal completes tasks only when pressured to do so; is satisfied with minimal progress; only does what is required

Average completes tasks easily; seeks to obtain maximal performance; willing to seek advice and help when needed

Role Model is a role model for others to follow; goes above and beyond what is expected; helps others

Partnering/Networking

What does Partnering/Networking mean?
It means that ...

• You promote the understanding of how the department affects the organization overall.
• You partner with peers to obtain influence within the Company.
• You collaborate with others to accomplish goals and objectives.
• You capitalize on partnerships and networks to enhance the Company's bottom line.
• You forge mutually beneficial relationships between individuals with diverse backgrounds.

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

Not Applicable or Unable to Judge

Poor does not perform to expected standards; often unable to complete tasks; does not seek help or advice

Minimal completes tasks only when pressured to do so; is satisfied with minimal progress; only does what is required

Average completes tasks easily; seeks to obtain maximal performance; willing to seek advice and help when needed

Role Model is a role model for others to follow; goes above and beyond what is expected; helps others

Adaptability

What does Adaptability mean?
It means that ...

• You recognize and implement changes to enhance efficiency and effectiveness.
• You develop insights and apply innovative solutions to projects and problems.
• You perform a wide range of tasks, respond to changes in direction and priorities and accept new challenges, responsibilities, and assignments.
• You are able to work effectively with new people and new teams.
• You are willing to change ideas or perceptions based on new information or contrary evidence which is presented.

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

Not Applicable or Unable to Judge

Poor does not perform to expected standards; often unable to complete tasks; does not seek help or advice

Minimal completes tasks only when pressured to do so; is satisfied with minimal progress; only does what is required

Average completes tasks easily; seeks to obtain maximal performance; willing to seek advice and help when needed

Role Model is a role model for others to follow; goes above and beyond what is expected; helps others

Strengths


Areas for Development


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