Abridged Sample Questionnaire                                           Return to previous page                                         

The items in the Nordli, Wilson 360 Feedback questionnaire can be specifically tailored
to the individual and leadership competencies important to your business.  The feedback
questionnaire can be completed online through the world wide web or in paper and pencil
form. The items shown below are a small sample of actual items. For a more extensive
review of items, competencies and customization contact us at Nordli, Wilson Associates.

NORDLI, WILSON ASSOCIATES
360 Feedback Questionnaire

This feedback is on: 

Please check one:

I am this person's manager
 I report to this person
 I am this person's co-worker, colleague or peer
 I am this person

This form is an opportunity to provide constructive feedback to the person named above.  The items in this form describe behaviors which are building blocks of the core competencies, skills and qualities valued in the culture of many successful organizations.

Following the items, there are some open-ended questions asking  you to elaborate or to address additional issues.  Your responses here will be collated with the responses of others and presented as feedback in an anonymous and verbatim fashion.

The objective here is to be helpful to the individual to  whom the feedback is directed, so please be as communicative as possible. Good feedback entails "telling the truth constructively."  It is important that you be balanced, candid and forthright.

Please respond to all items by clicking on the appropriate button

Strong Need
for
Development
  1		 Moderate
Need for
Development
2
Demonstrates
Skill
3
Area of
Strength
4


Exceptional
Strength
5


No Opinion

N

 

1.

 Demonstrates business knowledge and savvy
1 2 3 4 5 N

2.

 Holds people accountable
1 2 3 4 5 N

3.

 Speaks up challenges the status quo
1 2 3 4 5 N

4.

 Confronts problem employees in a timely manner
1 2 3 4 5 N

5.

 Fosters innovation and creativity
1 2 3 4 5 N

6.

 Quickly sizes up business challenges
1 2 3 4 5 N

7.

 Is decisive
1 2 3 4 5 N

8.

 Uses authority fairly
1 2 3 4 5 N

In answering these open-ended questions please be as constructively candid as possible.  Please not that your
statements will be transcribed verbatim and presented to the individual combined with transcribed
statements from others.

1. What are some things you believe this person does (or you do, if this is a self-report)
     particularly well that contribute to the success of the organization?

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