Performance - 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 .

Performance	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
Able to organize work.
Effective in performing his/her job.
Effectively organizes resources and plans
Works well in this position.
Works effectively in the department.
If [Participant Name] were to make improvements in Performance, what are your suggestions for how he/she can improve this?
Responsible	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
Completes assigned work tasks.
Acts as a resource without removing individual responsibility.
Behavior is ethical and honest.
Sets high personal standards of performance.
Sets a good example.
If [Participant Name] were to make improvements in Responsible, what are your suggestions for how he/she can improve this?
Empowering Others	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
Expresses confidence in the abilities of others.
Supports the decisions of others.
Assigns tasks that are within the skill levels of employees.
Distributes the workload to subordinates.
Gives employees the opportunity to make their own decisions at work.
If [Participant Name] were to make improvements in Empowering Others, what are your suggestions for how he/she can improve this?
Partnering/Networking	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
Supports a partnering/networking culture.
Promotes the understanding of how the department affects the organization overall.
Maintains infrastructure to support partnerships and networks.
Develops a sense of trust in subordinates so they can freely interact and share information with others.
Partners with peers to obtain influence within the Company.
If [Participant Name] were to make improvements in Partnering/Networking, what are your suggestions for how he/she can improve this?
Teamwork	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
Is open to new ideas that may change own goals for benefit of the team
Encourages others to share ideas to develop team cohesion
Coaches team members to work toward a common goal.
Provides assistance and support to other team members when needed
Fosters teamwork rather than individual competition
If [Participant Name] were to make improvements in Teamwork, what are your suggestions for how he/she can improve this?
Others	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
Able to see issues from others' perspectives.
Helpful
Consistently demonstrates ability and willingness to trust others.
...treats others with respect and dignity.
Forms working relationships with employees from other departments.
If [Participant Name] were to make improvements in Others, what are your suggestions for how he/she can improve this?
Company	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
Understands how decisions impact other business units beyond their immediate department of work group.
Expresses loyalty and dedication to [Company] in interactions with others.
Follows existing procedures and processes.
Impresses upon others the important aspects of [Company].
Attends [Company] gatherings and social events.
If [Participant Name] were to make improvements in Company, 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.