Part I: Basic Information
1.
Name:
*
Email :
*
Phone :
*
2.
Organization :
3.
4.
Please indicate your role within the organization.
Part II: Questions about the people in your organization.
1.
How many employees are in your organization?
Of the total employees, how many are full time?
How many are part time?
2.
How many members are on your Leadership Team?
3.
Of the Leaders on your team, please indicate the generational make up (This will help us discuss the context of your team.).
Boomer ( ages 46 and up)
Gen-X ( ages 30 to 45 )
Millenials ( ages 18 to 30)
Part III: Questions about Organizational Strategies and Goals
1.
What are the top three things that are working best for your organization right now?
2.
What are the top three opportunities yet to be realized?
3.
What are the top three constraints holding the organization back from achieving next level performance?
4.
Please take a few moments to describe your best mental image of what you would like the organization to become in the future.
5.
Briefly describe any areas of the organization that may receive limited attention or resources which may become an obstacle to success in the future.
6.
Please describe top 5 budget priorities.
7.
Please describe how revenue growth has changed over the past few years. Also please write how this makes you feel as a leader. Does this contribute to the positive mental image you described earlier?
8.
Please describe the business’ impact on the market over the last 3 years. Also please write how this makes you feel as a leader. Does this contribute to the positive mental image you described earlier?
Part IV: Questions about the context of your organization. Directions: Please read through the following statements.
On a scale of 1 – 5, with 5 being the highest , rank your level of agreement with each of the statements. When possible, avoid choosing #3; force yourself to select a higher or lower rating.
1.
All team members exceed productivity goals.
2.
Decision making is filtered through a Customer Value focus.
3.
Organizational processes facilitate customer service for customer retention.
4.
Staff turnover is non-existent in our organization.
5.
We continually improve our processes focused on improving customer value and satisfaction.
6.
There is a culture of leadership development throughout the organization.
7.
Long-term profit and growth is grounded in, and sustained by, a positive work environment.
8. We have a clear set of performance measures that drives understanding of future financial success.
Part V:
Questions about the context of your team.
Directions: Please read through the following statements.
On a scale of 1 – 5, with 5 being the highest , rank your level of agreement with each of the statements. When possible, avoid choosing #3; force yourself to select a higher or lower rating.
1.
As team leader, I provide clear, elevated goals intended to stretch team members' capabilities and focus on achieving results.
2.
Our team structure is designed to best serve our customers, and enhances our ability to reach team goals.
3.
Competent team members are defined by their supportiveness and positive personal style.
4.
We have a collaborative work climate based on trust, openness, honesty, and respect. We work through conflicts as they come up.
5.
As team leader, a critical part of my role is to remove obstacles and create opportunities for team members' success.
6.
Each team member has a clear understanding of the significance of their contributions and performance expectations are clearly defined .
7. I intentionally develop team members to be team leaders.
8. Learning and growth opportunities for staff drive long-term profit and growth for the organization.
Part VI. Questions about the context of your leadership. Directions: Please read through the following statements.
On a scale of 1 – 5, with 5 being the highest , rank your level of agreement with each of the statements. When possible, avoid choosing #3; force yourself to select a higher or lower rating.
1.
I appropriately implement the full-range leadership model.
2.
I am aware the impact of my personal energy level and optimism and when they affect the organizations performance levels.
3.
I have a leadership development process / system within my organization.
4.
I do not sustain a consistent leadership style from one situation to the next.
5.
I accept responsibility and expect to be held accountable for the effectiveness of my leadership.
6.
I do not need to get the credit for a job well done.
7.
I am actively engaged in developing my successor.
8. I can effectively balance focus on tasks and focus on relationships.
VII: Demographics Please select the correct answer.
1.
What is your age?
A. Under 20B. 20 - 29C. 30 - 39D. 40 - 49E. 50 - 59F. 60 or over
2.
What is your gender?
A. MaleB. Female
3.
How long have you worked your industry?
A. less than 5 years B. between 5 and 9 years C. between 10 and 19 yearsD. between 20 and 29 years E. more than 30 years
4.
What are your total work hours (number of hours) for a typical work week?
