Self - Assessment Sample

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This a sample of the 360 Self-Assessment survey. In this example, you will be completing questions related to your role as a Communicator. A sample report will be generated showing your self-assessment scores compared to how your fictitious group of co-workers rated you. Your self-scores are not folded into the average scores.

Please Note The Following:

  • Once you have completed the instrument you must hit the submit button at the bottom of the page.

  • If you would like more information of the 360 Leadership Tool, you may email the survey office at soe@uts.cc.utexas.edu or call (512) 471-9831.

  • This is only a sample of our 360 instrument - to view the complete instrument, please contact our office..

  • If your Browser does not support Applets - the Report may not appear or print correctly. View a sample report in PDF Format 

 

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Enter Your Information Below: 

Name:

Instructions:
 For each of the items, select the how strongly you agree or disagree that you 
demonstrate the characteristics listed. For example, a good way to read each items is, 
"I . . . share important information and keep others updated.

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Share important information and keep others updated.
Strongly Disagree Disagree Feel Neutral Agree Strongly Agree N/A

Express information and priorities clearly.
Strongly Disagree Disagree Feel Neutral Agree Strongly Agree N/A

Write clearly and concisely.
Strongly Disagree Disagree Feel Neutral Agree Strongly Agree N/A

Listen carefully.
Strongly Disagree Disagree Feel Neutral Agree Strongly Agree N/A

Ask for input.
Strongly Disagree Disagree Feel Neutral Agree Strongly Agree N/A

Get back with answers to questions.
Strongly Disagree Disagree Feel Neutral Agree Strongly Agree N/A

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You have completed the feedback instrument.  

To submit your responses, click the submit button

To Erase and Reset this form, click the reset button:

The Survey of Organizational Excellence Home Page
Last Update: July 10, 2002
Questions and comments to: soe@uts.cc.utexas.edu
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