360 Feedback Questionnaire

This is an example of a 360 Feedback Questionnaire. 360-Feedback uses on-line questionnaires to gather information from Self, Manager(s), Peers, Direct Reports, and others. This information provides different perspectives.

Below is a sample 360 Feedback questionnaire. This example demonstrates the use of the 360-Feedback Questionnaire for employee development. This example shows 7 competencies:

  • Communication Skills
  • Attitude
  • Teamwork
  • Conflict Management
  • Interpersonal Skills
  • Leadership
  • Trustworthy


Your feedback is an important part of our performance management program. 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 an ongoing effort to reinforce job performance fundamentals, you are asked to respond to the statements that follow. Please read each statement carefully, refer to the rating scale provided, and decide to what extent you engage in the behavior described.

You will use a 5-point rating scale, from 'Never' to 'Always'.

In assessing each statement please ensure your selection accurately reflects your experience (i.e., do not respond on the basis of "what you would like to do" or, "what you think the right answer is.") Respond on the basis of your actual behavior. At the end of the questionnaire are a few text boxes to allow you to elaborate on your responses.

When you have completed the assessment click "Submit." Your assessment will be processed and combined with the feedback you received from others. You will receive summary feedback at the conclusion of this survey project.

The data you receive will be confidential. This Leadership Feedback exercise is intended for your ongoing growth and development.

To what extent do you typically engage in the following behaviors?

Communication Skills

Never Seldom Sometimes Often Always
  1. An effective listener who is responsive to information needs.
  1. Chooses the communication medium (ie. email, voice mail, memo, project document) that reflects the needs of the content (ie. urgency, confidentiality, content scope).
  1. Communicates effectively with all levels of the organization.
  1. Achieves good communications with college leadership.
  1. Delivers difficult/sensitive messages to co-workers in an appropriate manner.
  1. Present their message with professionalism.
  1. Inspires others to take action based on his/her communications.
  1. Is an effective and motivating communicator.


Never Seldom Sometimes Often Always
  1. Builds open and trusting relationships.
  1. Shows by their actions that they trust in the positive intentions of others.
  1. Treats all people fairly and with respect.
  1. Demonstrates empathy for the impact of change on people and processes
  1. Projects a "can-do" attitude when interfacing with peers, subordinates and customers (especially during difficult and challenging times).
  1. Maintains self-control in conversations.
  1. Deals with difficult situations calmly and confidently.
  1. Contributes to a positive and fun work environment.
  1. Encourages and is receptive to working out problems and challenges --- no reluctance from team members to come forward with concerns/issues.


Never Seldom Sometimes Often Always
  1. Is an effective teamplayer.
  1. Builds consensus and shares relevant information.
  1. Encourages teamwork and collaboration.
  1. Fosters respect and understanding among team members.
  1. Is open to new ideas that may change own goals for benefit of the team.
  1. Seeks and listens to other’s contributions.
  1. Works cooperatively with others to solve problems.
  1. Creates a culture that fosters and values collaboration.
  1. Models excellent team behavior; recognizes “out-of-bounds” behavior and addresses as appropriate.
  1. Relates to all kinds of people tactfully.
  1. Creats a climate that encourages team participation.

Conflict Management

Never Seldom Sometimes Often Always
  1. Facilitates conflict resolution discussions between individuals or teams.
  1. Facilitates constructive dialog with stakeholders.
  1. Successfully resolves conflicts and grievances to a win-win solution.
  1. Identifies and takes steps to prevent potential confrontations.
  1. Identifies potential opportunities for compromise.
  1. Assists team members by helping them see the other point of view.
  1. Helps employees to think through alternative ways to resolve conflict situations.
  1. Tries to understand others' point of view before making judgments.

Interpersonal Skills

Never Seldom Sometimes Often Always
  1. Uses tact, compassion, and sensitivity in interactions with others.
  1. Creates an atmosphere that supports the open expression of ideas.
  1. Values the opinions of others.
  1. Demonstrates an understanding of other points of view.
  1. Demonstrates awareness of how specific actions, or inaction, could affect others.
  1. Defuses hostile/angry individuals in group settings to prevent disruption of work.
  1. Establishes good rapport with employees and others.
  1. Demonstrates compassion and respect for others through actions; is concerned about their work and non-work issues.
  1. Positively impacts his/her team's morale, sense of belonging, and participation.
  1. Is open and approachable.
  1. Listens to others, withholding judgment, and comes across as open to all viewpoints.


Never Seldom Sometimes Often Always
  1. Communicates calmly and honestly with co-workers, customers, and supervisors, even when stressed.
  1. Motivates and challenges employees to attain a shared vision.
  1. Clearly communicates the importance and thought process behind College of Lake County and area vision, thus inspiring others to work toward key objectives
  1. Communicates frequently with entire core team to ensure inter-departmental alignment and collaboration to accomplish objectives
  1. Demonstrates effective leadership talent and skills.
  1. Gains cooperation, support, and buy-in of others.
  1. Sets a positive example admired by others.
  1. Encourages innovation and creativity by others.
  1. Critiques own performance as a means of self-improvement and initiates self-development activities


Never Seldom Sometimes Often Always
  1. Is a person you can trust.
  1. Maintains high ethical standards.
  1. Consistently demonstrates high personal standards of ethical judgment.
  1. Demonstrates congruence between statements and actions.
  1. Communicates an understanding of the other person's interests, needs and concerns.
  1. Builds and maintains the trust of others.
  1. Takes care to maintain confidential information.
  1. Works in a way that makes others want to work with her/him.
  1. Is trusted by peers and co-workers; others are willing to confide in him/her.

    In the spaces provided below, please type in any comments/feedback about yourself that you believe are relevant to your development.

  1. What would make you more effective in your job?

  2. What changes should you make in order to develop professionally?

  3. What do you think your supervisor wants you to concentrate your efforts on?