Leadership - 360 Degree Feedback Template #5

360-Degree Assessment Survey

Dear Employee:

Thank you for participating in a 360-degree feedback assessment. In this process, you will complete a self-assessment questionnaire (below). You will also receive feedback from others including your manager, peers and direct reports. As you respond, please respond using just your experiences in the past 12 months. Rate each item using the scale shown. Comments can be very helpful; at a minimum where you give a particularly high or low rating, please share your reasons in the Closing Comments section. Your responses will be compiled with feedback from others and presented to you at the conclusion of this assessment to help guide your ongoing professional 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.

Please ensure that your submission is made by .

Thank you for your participation in the survey.

Management Team

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Leadership	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You actively listen for feedback from subordinates.
You expect staff to work above average.
You remove performance barriers by providing necessary systems, information, tools, and resources people need to do your jobs and develop.
You mentor others.
You have resilience to pick yourself up after a defeat.
Juggling Multiple Responsibilities	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You ensure that assignments are prioritized according to the needs of the department/company.
You recognize and respond to product placement and signing needs while staying alert to customers' needs, store activities and training associates.
You determine which tasks are critical and which tasks are optional.
You avoid bottlenecks in progress by assigning multiple individuals to critical tasks.
You build in extra time in the schedule for unplanned events/occurrences.
Trustworthy	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You are trustworthy; is someone that can be trusted.
You take ownership, deliver on commitments
You demonstrate a sense of responsibility and commitment to public trust.
You deliver on promises made.
You demonstrate congruence between statements and actions.
Responsible	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You act as a resource without removing individual responsibility.
You hold yourself accountable to goals / objectives
You work in a way that makes others want to work with you.
You are a person others can trust.
You take personal responsibility for results.
Coaching	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You provide new ideas and suggestions to stimulate development and growth.
You help others to identify key goals and use your talents to achieve success.
You help the employee to understand factors impacting the organization
You understand and respect the employee's unique perspectives and challenges.
I encourage employees to reflect on their experiences, behaviors, and decisions.
Business Acumen	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You can effectively interpret and analyze market data.
I seek to better understand other areas of the company, including their operations, personnel, and output.
You periodically assess the current market environment.
You foster a critical analysis of events and issues.
I establish clear, long-term objectives that align with the company's vision and mission.
Strategic Insight	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You integrate financial, operational, and marketing data to guide strategic priorities and resource allocation.
You develop a plan and strategy for each functional area within the mission statement.
You allocate proper resources for employee training to meet future needs based on insight into employee skill levels.
You maintain knowledge of current trends in the industry.
I observe employees at work to get better insight into the issues they are dealing with.
Fiscal Management	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You develop budgets and plans for various programs and initiatives.
You provide budgeting and accounting support to the Company.
You develop of the department's annual budget.
You monitor expenses and verify the need for items purchased.
You monitor spending.
Global Perspective	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You understand and appreciate the perspectives offered by others with different cultural backgrounds.
You are able to work with others from different cultures and countries.
You align personal vision with global strategies.
You are able to listen and understand others and discuss issues in a respectful way.
You can effectively deliver presentations to international clients.

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

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

    
    
47. Strengths
    
    
    
48. Areas for Development
    
    
    
49. Please give any final comments or suggestions for [Participant Name Here]'s assessment.