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First Name: Last Name:
Company Name: Email Address:
Will you be using our standard leadership competency model (See Below)? Yes No
  1. Communication
    • Gives clear and constructive feedback.
    • Is aware of their non-verbal demeanor.
    • Is able to refine their message for different audiences.
    • Gives effective presentations to deliver a specific message.
    • Comments
  2. Decision Making
    • Makes sound and timely decisions.
    • Considers the well-being of the people affected by the decision.
    • Separates the root cause from the symptoms.
    • Comments
  3. Energizing Others
    • Culitvates leaders in the organization.
    • Creates and promotes a learning culture.
    • Rewards employees for a job well done.
    • Comments
  4. Integrity
    • Demonstrates personal character.
    • Makes fair decisions.
    • Openly shares relevant and important information.
    • Comments
  5. Leadership
    • Oversees the work but does not micromanage.
    • Involves everyone and welcome ideas from everywhere.
    • Leads by example (walks the walk).
    • Comments
  6. Leading Change
    • Takes risks in moving away from the status quo.
    • Clearly articulates the need for change.
    • Accepts responsibility for unpopular decisions related to a change effort.
    • Comments
  7. Vision
    • Articulates a clear vision to all levels of the organization.
    • Set a clear direction for the business.
    • Helps employees understand how they contribute to achieving business objectives.
    • Comments
Will you be using our standard 5 point scale (See Below)? Yes No
  1. Almost Never
  2. Rarely
  3. Sometimes
  4. Usually
  5. Almost Always
How many assessments will be initiated?
self/manager assessments
multi-rater assessments
Please note that multi-rater assessments should include a self rating (the person initiating the assessment, their manager, a sampling of their direct reports and a sampling of their peers. Multi-rater assessments MUST have no less than 7 and no more than 12 raters including self.
The standard start to finish date for an assessment is 30 days (ie; start date Jan 1 – expiration date Feb 1). If you would like a different time frame , please indicate that here:

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