Achievement - 360 Degree Feedback Survey Sample #8

Self-Assessment Instructions

You have been selected to complete a self-assessment questionnaire as part of a 360-degree feedback assessment. 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.

Respond to the assessment form based on your work experiences during the previous 12 months. Your responses will be merged with other people's feedback and presented to you in your on-going development. Comments from others will be shared anonymously, as written.

Method of use: As part of the review process, managers will receive feedback from peers and staff. It is recognized that not all participants will be able to assess an individual's performance in all areas. The feedback received will be utilized as input to the manager's performance and on-going development plan.

You may sign out at any time by pressing the Save button at the end of the form and then closing your browser. You may return later to pick up where you left off. When you are done, press the Complete button.



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Achievement	Agree	Unsure	Disagree	N/A
You strive to exceed standards of performance.
You strive to meet goals and objectives.
I can complete required training and certification.
You allocate resources as needed to accomplish organizational goals.
You take reasonable risks to achieve desired results.
Results Oriented	Agree	Unsure	Disagree	N/A
You pursues performance benchmarks despite obstacles and setbacks.
I strive to exceed performance benchmarks.
You help others when free-time is available.
You track individual and team contributions against goals and communicate outcomes transparently.
You coordinate cross-functional efforts to ensure dependencies are addressed proactively.
Excellence	Agree	Unsure	Disagree	N/A
You keep yourself and others focused on constant improvement.
You demonstrate the functional or technical skills necessary to do your job.
You are planful and organized.
You produce high quality work.
You take a lot of pride in your work.
Interpersonal Skills	Agree	Unsure	Disagree	N/A
I am transparent and honest in communications, intentions, and actions.
You use knowledge and charisma rather than position, power, or coercion to influence others
You maintain open and regular communication with others.
You communicate well at all levels of the organization.
You a good listener who is attentive to others.
Passion To Learn	Agree	Unsure	Disagree	N/A
You take initiative for own learning and development.
You enhance your value to the company through additional training and development.
You demonstrate through personal behavior the commitment to high standards of performance.
You demonstrate a willingness to participate in continuing education courses.
You are open to feedback from others.
Continual Improvement	Agree	Unsure	Disagree	N/A
You are open to the suggestions from others.
You encourage an employee culture of continuous improvement to seek out better ways of doing things.
You look for ways to improve work processes and procedures.
You look for ways to expand current job responsibilities.
You look for ways to expand and learn new job skills.
Management	Agree	Unsure	Disagree	N/A
You create a strategy for achieving departmental objectives.
You delegate authority and responsibility to subordinates and hold them accountable for their actions.
I use discipline as a tool for growth, focusing on feedback and learning rather than punishment.
I create growth opportunities for employees.
You integrate diverse skill levels and opportunities for growth of employees to ensure cohesive and effective project implementation.
Persuasion and Influence	Agree	Unsure	Disagree	N/A
You are successful in describing and communicating an image of the problem.
You get others to adopt new positions or ways of do things.
You gain acceptance from employees for new ways of working.
You gather data and stakeholder perspectives in advance to anticipate resistance and tailor persuasive approaches.
You advocate consistently for decisions aligning with ethical and organizational values, even when unpopular.
Goals	Agree	Unsure	Disagree	N/A
I demonstrate a track record of successfully accomplishing a wide range of goals, spanning various areas and disciplines.
You set goals that are both realistic and challenging to achieve.
You create goals based on the specific needs and challenges of each task or project.
You strategically plan activities, resources, and personnel to ensure that progress is made on all current goals.
You foster a disciplined work ethic, allowing for steady progress and the achievement of goals within the designated time frame.
Customer Focus	Agree	Unsure	Disagree	N/A
You received good feedback from customers.
I respond to feedback from customers.
I maintain up-to-date information regarding customer products.
You focus on maintaining good relationships with customers.
I identify opportunities that enhance the customer's experience.
Partnering/Networking	Agree	Unsure	Disagree	N/A
I am comfortable working in partnership with colleagues from other departments.
You strive to cultivate and sustain trustful and committed relationships with all partners.
You regularly attend conferences and seminars to meet with others in the industry.
You create value within the Company by building networks.
I enter into licensing agreements to share intellectual property.
Business Acumen	Agree	Unsure	Disagree	N/A
I describe and summarize data.
You anticipate marketplace opportunities and supports speed to market.
I recognize the individual needs of customers.
You understand the dynamics of our industry.
You keep informed of current income and expenses.
Strategic Insight	Agree	Unsure	Disagree	N/A
You let employees know how their roles contribute toward the achievement of strategic company objectives.
I demonstrate knowledge of organizational history, values, and long-term goals when making strategic recommendations.
You formulate policies and strategies for addressing the Company's important challenges.
I anticipate talent needs based on projected business growth and industry developments.
You leverage internal expertise and external partnerships to expand strategic capabilities.
Planning	Agree	Unsure	Disagree	N/A
You are able to look ahead (beyond the present) when addressing the work/needs of the department.
I can reorder the schedule of events to maximize attendance/efficiency.
I encourage others to follow the plan.
You have developed an effective strategic plan.
You create to-do lists to make sure nothing is missed.

71. Overall, please rate the effectiveness of [Participant Name Here].
    

    5- Very Effective 4- Effective 3- Neither 2- Ineffective 1- Very Ineffective

    
    
72. Strengths
    
    
    
73. Areas for Development
    
    
    
74. Please give any final comments or suggestions for [Participant Name Here]'s assessment.