360 Degree Feedback

Completion

For each question you have 5 options:-

N - Never
R - Rarely
S - Sometimes
F - Frequently
A - Always

If you feel that a question is either not applicable or you have insufficient information about the person use the N/A - Not Applicable option

 

 

Section One - Subject Details

 
Your name    First Name
     Last Name
Organisation

 

Section Two - Admin
Please help us with the administration of your report by indicating how many forms you have sent out to the various respondents.  Your e mail address will help us to contact you if there appears to be a short fall between what you have requested and what we have received.

No of forms given to managers (max 4)   

No of forms given to colleagues (max 12)   

No of forms given to direct reports (max 12)   
No of forms given to others (customers, clients, etc) (max 6)   

Your e mail address   

  

 

Section Three - 360 Questionnaire
Q This Person........  
1 Seeks feedback and acts on it N    R   S   F   A   N/A
2 Readily commands respect N    R   S   F   A   N/A
3 Involves others in shaping plans and decisions that affect them N     R   S   F   A   N/A
4 Helps others to identify their development needs through feedback and discussion N     R   S   F   A   N/A
5 Instils confidence in others and empowers them to take initiative N     R   S   F   A   N/A
6 Displays a high energy level N     R   S   F   A   N/A
7 Interacts with people openly and directly N     R   S   F   A   N/A
8 Speaks clearly and concisely N     R   S   F   A   N/A
9 Speaks effectively in front of groups N     R   S   F   A   N/A
10 Establishes networks with people inside and outside the company N     R   S   F   A   N/A
 
11 Has a ‘gut feel’ for doing what is right N     R   S   F   A   N/A
12 Works effectively in ambiguous situations N     R   S   F   A   N/A
13 Considers alternative solutions before making decisions N     R   S   F   A   N/A
14 Converts long term strategic thinking into action N     R   S   F   A   N/A
15 Applies creative and innovative solutions to problems N     R   S   F   A   N/A
16 Understands the dynamics of the market place N     R   S   F   A   N/A
17 Learns from own mistakes N     R   S   F   A   N/A
18 Inspires others to excel N     R   S   F   A   N/A
19 Values the contribution of all team members N     R   S   F   A   N/A
20 Coaches others to improve N     R   S   F   A   N/A
 
21 Is driven by his/her inner personal beliefs N     R   S   F   A   N/A
22 Is well organised N     R   S   F   A   N/A
23 Listens carefully to input before speaking N     R   S   F   A   N/A
24 Gets point across when talking N     R   S   F   A   N/A
25 Prepares well for presentations N     R   S   F   A   N/A
26 Uses networks to get things done N     R   S   F   A   N/A
27 Manages the paradoxes of organisational life for themselves and others N     R   S   F   A   N/A
28 Prepares people to understand change N     R   S   F   A   N/A
29 Makes link between team mission/aim and company strategies N     R   S   F   A   N/A
30 Makes sound decisions based on available information N     R   S   F   A   N/A
 
31

Challenges people to think in new ways

 N     R   S   F   A   N/A
32 Takes decisions for the good of the company N     R   S   F   A   N/A
33 Accepts criticism openly and non-defensively N     R   S   F   A   N/A
34 Provides clear direction and defines priorities for the team N     R   S   F   A   N/A
35 Encourages and embraces diversity N     R   S   F   A   N/A
36 Regularly reviews team performance against objectives N     R   S   F   A   N/A
37 Projects an appropriate degree of self confidence N     R   S   F   A   N/A
38 Manages his/her time well N     R   S   F   A   N/A
39 Questions to seek clarification N     R   S   F   A   N/A
40 Gives persuasive reasons for ideas N     R   S   F   A   N/A
 
41

Responds well to close questioning when presenting

 N     R   S   F   A   N/A
42 Is easily approached N     R   S   F   A   N/A
43 Maintains disciplined attention; focuses on doing the ‘right stuff’ N     R   S   F   A   N/A
44 Involves others in the process of change N     R   S   F   A   N/A
45 Actively identifies and addresses long term issues N     R   S   F   A   N/A
46 Applies logic in solving problems N     R   S   F   A   N/A
47 Identifies the opportunities in problems N     R   S   F   A   N/A
48 Stays up to date with competitor information N     R   S   F   A   N/A
49 Understands own personal strengths and weaknesses N     R   S   F   A   N/A
50 Sets high personal standards N     R   S   F   A   N/A
 
51

Manages conflict in team to a positive/win:win conclusion

 N     R   S   F   A   N/A
52 Regularly reviews individual performance, formally and informally N     R   S   F   A   N/A
53 Has confidence in themselves; which manifests itself as appropriate personal presence N     R   S   F   A   N/A
54 Has a high work capacity N     R   S   F   A   N/A
55 Prepares self to listen actively N     R   S   F   A   N/A
56 Speaks with energy and enthusiasm N     R   S   F   A   N/A
57 Runs effective meetings N     R   S   F   A   N/A
58 Knows who to involve and when N     R   S   F   A   N/A
59 Is ambitious N     R   S   F   A   N/A
60 Keeps people up to date with information N     R   S   F   A   N/A
 
61

Focuses on most important issue without getting lost in detail

 N     R   S   F   A   N/A
62 Analyses problems from different points of view N     R   S   F   A   N/A
63 Challenges ‘the way it has always been done’ N     R   S   F   A   N/A
64 Understands the economics of the company N     R   S   F   A   N/A
65 Seeks out learning opportunities N     R   S   F   A   N/A
66 Understands what motivates others N     R   S   F   A   N/A
67 Encourages the team to own their part of the ‘Vision’ N     R   S   F   A   N/A
68 Gives clear, concise and effective feedback to others N     R   S   F   A   N/A
69 Gets the Job done on time N     R   S   F   A   N/A
70 Creates environment for effective listening N     R   S   F   A   N/A
 
71 Adjusts approach to audience N     R   S   F   A   N/A
72

Keeps meetings ‘on track’

 N     R   S   F   A   N/A
73 Develops effective working relationships outside of own team N     R   S   F   A   N/A
74 Treats others with the respect and dignity. Acts with integrity and honesty N     R   S   F   A   N/A
75 Is prepared to consider new ideas and to change the way they do things N     R   S   F   A   N/A
76 Understands the history and culture of the company N     R   S   F   A   N/A
77 Able to transfer learning from one situation to another N     R   S   F   A   N/A
78 Fosters the development of a common vision N     R   S   F   A   N/A
79 Fosters teamwork N     R   S   F   A   N/A
80 Expresses disagreement tactfully and sensitively N     R   S   F   A   N/A
 
81

Knows the Job

 N     R   S   F   A   N/A
82 Can ‘read’ people accurately N     R   S   F   A   N/A
83 Represents the company well to customers N     R   S   F   A   N/A
84 Pursues focused self-development N     R   S   F   A   N/A
85 Supports management decisions N     R   S   F   A   N/A
86 Supports new and inexperienced members N     R   S   F   A   N/A
87 Confronts potential people problems early N     R   S   F   A   N/A
88 Handles multiple demands and competing priorities N     R   S   F   A   N/A
89 Maintains confidentiality N     R   S   F   A   N/A
90 Knows when and how to delegate N     R   S   F   A   N/A
 
91 Has the ‘edge’ to make and take tough decisions N     R   S   F   A   N/A
 
 

 

Section Four - Importance factors

This section is an opportunity for you and your manager to share perspectives on how important you regard various factors are in relation to the job.  Below are 16 factors (plus a short description giving more detail about each factor).
Study each factor and determine the relative importance of each one to the subjects job as it currently stands.  Against each factor choose one of the three option 'A' 'B' 'C' 'D' 'E' or 'F'.  As the diagram below indicates F is more important than E which in turn is more important than D.  
You can only use each level of importance four times, after which you must choose another level of importance.  This is done deliberately to ensure that there is a spread of responses. 

Factor

Description

Importance
Learning Learning quickly and pursuing self development  A   B   C

D   E  F  

Leadership Providing direction and motivation and being a good role model.  A   B   C

D   E  F  
Managing Teams Valuing and involving team members to achieve the teams goals  A   B   C

D   E  F  
Developing Others Reviewing, supporting and encouraging others to achieve higher levels of performance  A   B   C

D   E  F  
Confidence Having an appropriate level of confidence in themselves and building confidence in others  A   B   C

D   E  F  
Personal Effectiveness Being well organised and using time and energy effectively  A   B   C

D   E  F  
Listening Demonstrating in word and deed that they listen  A   B   C

D   E  F  
Speaking Communicating clearly and concisely  A   B   C

D   E  F  
Presentations and Meetings Making effective presentations and running good meetings A   B   C

D   E  F  
Networks Building and using networks to achieve goals A   B   C

D   E  F  
Emotional Intelligence Self motivated and socially skilled; can manage and detect the emotions in self and others A   B   C

D   E  F  
Managing Change Working effectively in changing situations; preparing self and others for change A   B   C

D   E  F  
Strategic Thinking Taking a long term view and identifying key issues without getting lost in the detail A   B   C

D   E  F  
Analytical Thinking Analysing data and using careful logic to make decisions A   B   C

D   E  F  
Creative Thinking Thinking differently to create new ideas and solutions A   B   C

D   E  F  
Commercial Awareness Being aware of the commercial aspects of the organisation and its business context A   B   C

D   E  F  
Please check that you have not used any one rating level more than four times in the above answers.

 

Section Five - Comments

Use the space below to make any relevant (and brief) comments or to give further information that you feel may be useful; in particular what you feel that the person should Start, Stop or Continue doing that would make them even more effective in their role:

 

 Section Six - Submission

Thank you for taking the time to fill out this questionnaire.  Please take a moment to review your responses to ensure that you have not left any blank.

 You must press the Submit button below to send your responses.  You only need press the button once (depending on the speed of your connection, time of day etc it may take up to a minute to send your data). 

               

See the sample 360 Degree Feedback report