1. What is your relationship to this person you are rating? (select one)

Direct supervisor Peer (same level in org) Direct Report Customer Self

As a Model to Others....

2. Is a personal model of good character, high ethics and integrity to those in and outside the organization.

Disagree Strongly Disagree Neither Agree nor Disagree Agree Agree Strongly

3. Walks the talk: avoids saying one thing and doing another.

4. Is careful to keep promises and honor commitments.

5. Is emotionally balanced: steady, cool under pressure, confident under stress.

6. Is flexible and able to adjust to changing circumstances.

7. Is personally inspiring to me: I am drawn to follow him/her!

As a Visionary....

8. Effectively communicates a shared vision of the future; inspires others by enthusiastically embracing the future vision.

Disagree Strongly Disagree Neither Agree nor Disagree Agree Agree Strongly

9. Establishes and communicates organizational values consistent with the vision.

10. Involves others in creating our vision for the future.

As a Leader....

11. Brings the best out of people by providing positive coaching, feedback and reinforcement.

Disagree Strongly Disagree Neither Agree nor Disagree Agree Agree Strongly

12. Delegates effectively: provides tasks and responsibilities to associates based on their knowledge, skills, abilities and development needs.

13. Develops a sense of ownership in others by involving them in decision making and action planning.

14. Provides excellent feedback to others on a regular and helpful basis.

15. Develops others by encouraging their growth: provides opportunities for them to stretch and develop.

16. Leads meetings well: meetings are organized, fast-moving, effective, and efficient.

17. Resolves conflict in a timely manner: does not allow personnel problems and interpersonal problems to fester.

18. Handles discipline appropriately: people are not allowed to "get away with stuff."

19. Isn't afraid to step up to the plate and LEAD when we need them to!

As a Communicator....

20. Contributes to discussions, actions and projects in a ways that lead to shared responsibility and shared success.

Disagree Strongly Disagree Neither Agree nor Disagree Agree Agree Strongly

21. Communicates effectively with co-workers; listens effectively and responds to the needs of others.

22. Communicates effectively with employees in other departments; listens effectively and responds to the needs of others.

23. Listens effectively and empathically and takes action on what he or she hears.

24. Is easy and comfortable to talk to: I feel I can approach him/her with my problems.

As a Teambuilder....

25. Promotes teambuilding: creates a feeling of a team working together.

Disagree Strongly Disagree Neither Agree nor Disagree Agree Agree Strongly

26. Establishes and builds trust: up, down and across the organization.

27. Gives credit to others on our team for their achievements.

As a Problem Solver....

28. Is a creative problem solver: challenges the process to find ways to improve things rather than maintaining the status-quo.

Disagree Strongly Disagree Neither Agree nor Disagree Agree Agree Strongly

29. Involves others in problem solving rather than taking it all on by himself.

30. Is an effective decision maker: makes timely decisions in the right way (involves others when appropriate but is not afraid to make "command decisions" when called for.

As a Manager...

31. Is organized and effective in his/her use of time and resources.

Disagree Strongly Disagree Neither Agree nor Disagree Agree Agree Strongly

32. Effectively manages our resources, including budgets, materials and people.

33. Gets the job done: meets or beats assigned deadlines and meets productivity goals.

34. Knows his or her job: has outstanding technical skills in needed areas.

35. Takes action without being prompted; seeks to do more than is required.

36. Is quality focused: strives for the highest quality and emphasizes this to others.

37. Is customer focused: knows the needs of internal and external customers and enables us to meet them.

38. How would you honestly rate this person in their current leadership/management skill?

Poor Fair Good Very Good Excellent

39. How much do you genuinely enjoy working for this leader?

Not Satisfied Somewhat Satisfied Satisfied Very Satisfied Extremely Satisfied

40. What do you consider to be his or her greatest strengths and assets to our company?

41. What would you recommend he or she work on to improve their leadership/management skills this year that would have the greatest positive impact?

42. What should he or she START doing as a manager that they now aren't doing?

43. What should they STOP doing that is holding things back?

44. What should he or she CONTINUE doing that you particularly appreciate?

45. What do you like best about working with this person?

46. Is there anything else, at all, that you would like to personally and confidentially relay to them that would help them become more effective?