Self Assessment Tool Form

Please rate your comfort level with the following actions.*

	Actively Avoid	Not Comfortable	Indifferent	Comfortable	Very Comfortable
Following up with teammates on late tasks they were in charge of completing
Speaking up when something makes you or another person feel uncomfortable
Choosing to lead a project or activity that requires learning or doing something out of your comfort zone
Convincing team members that your idea will improve the team or work flow

Select the best answer.*

	Disagree	Somewhat disagree	Neither agree or disagree	Somewhat agree	Agree
I take accountability when I fail to perform as expected.
I am resilient to organizational change (e.g., staffing, procedures, mission).
I will motivate colleagues and remain positive when in difficult times.
I recognize failure not as defeat but as a learning opportunity.
I work diligently to perform as expected, but also to influence others to do their best.

Rate your comfort level with the following actions.*

	Actively Avoid	Not Comfortable	Indifferent	Comfortable	Very Comfortable
Taking initiative to resolve a student inquiry or problem
Developing measurable goals and metrics for an activity or project
Assessing and evaluating an activity or project

Select the best answer.*

	Disagree	Somewhat disagree	Neither agree or disagree	Somewhat agree	Agree
I can anticipate potential problems within an activity or project.
I can identify the root of a problem, and provide an effective solution to the problem.
I evaluate multiple solutions to a problem before deciding on which one to take.

Please rate your comfort level with the following actions.*
Actively Avoid Not Comfortable Indifferent Comfortable Very Comfortable
Facilitating a meeting
Presenting in front of groups

Select the best answer.*

	Disagree	Somewhat disagree	Neither agree or disagree	Somewhat agree	Agree
I am confident drafting professional correspondence expressing ideas, desires, or concerns based on audience.
My written communication is often understood with little to no need for clarification.
I can be articulate, confident, maintain eye contact, use my voice expressively, and use few vocal filters ("um","uh", "like", "you know") in a meeting.
I pay attention and respond effectively to non-verbal cues when conversing with someone or presenting to groups.
I am aware of and know when to use basic email settings (reply, reply all, forward, CC, BCC, attachments)
I am aware of and know when to use advance email settings (out of office, signature, delayed delivery)
I can use social media platforms to engage users successfully.
I am confident selecting the right communication medium (email, call, text, video) when needing to convey information to someone else.

Please rate your comfort level with the following actions.*

	Actively Avoid	Not Comfortable	Indifferent	Comfortable	Very Comfortable
Helping resolve conflict among groups or team members who view things from a different perspective
Volunteering to be of service to a struggling or overwhelmed team member
Encouraging participation from all members of a team to complete the task at hand

Select the best answer.*

	Disagree	Somewhat disagree	Neither agree or disagree	Somewhat agree	Agree
I can adjust to work effectively with teammates who have strengths and weaknesses that differ from mine.
I am aware of cultural diverse work styles.
I balance my needs with the needs of others.

Select the best answer.*

	Disagree	Somewhat disagree	Neither agree or disagree	Somewhat agree	Agree
I come to work knowing what I need to accomplish by the end of the day.
I can focus on the task at hand without having to be instructed what to do on a day to day basis.
I accomplish my work when expected.

Select the best answer.*

	Disagree	Somewhat disagree	Neither agree or disagree	Somewhat agree	Agree
I access and evaluate multiple sources of information, including text and images, and synthesizes information to solve problems and create new insights.

Please rate your comfort level with the following actions.*
Actively Avoid Not Comfortable Indifferent Comfortable Very Comfortable
Seeking to address the world’s most pressing and enduring issues collaboratively and equitably.

Select the best answer.*

	Disagree	Somewhat disagree	Neither agree or disagree	Somewhat agree	Agree
I demonstrate an understanding of complex global issues and systems, and how issues and actions have local and global implications for the future.
I demonstrate effective stewardship of human, economic, and environmental resources.

Please rate your comfort level with the following actions.*
Actively Avoid Not Comfortable Indifferent Comfortable Very Comfortable
Seeking and considering feedback on work performance

Select the best answer.*

	Disagree	Somewhat disagree	Neither agree or disagree	Somewhat agree	Agree
I am aware of my biases and how those affect my work with others who have opposing views.
I am aware of my strenghts and weaknesses.
I aknowledge past experiences and feedback to make future decisions.
I am able to function without need for constant reassurance from others.

Please rate your comfort level with the following actions.*

	Actively Avoid	Not Comfortable	Indifferent	Comfortable	Very Comfortable
Accessing information and opportunities for career exploration
Taking steps to initiate a job search or seek advanced education
Self- advocating for opportunities in the workplace

Select the best answer.*

	Disagree	Somewhat disagree	Neither agree or disagree	Somewhat agree	Agree
I can develop a resume that has clear job objectives and evidence of knowledge, skills, and abilities relevant to the position or career desired.
I am aware and can articulate the transferable skills I posses.
I know how to prepare for an internview.

Please rate your comfort level with the following actions.*

	Actively Avoid	Not Comfortable	Indifferent	Comfortable	Very Comfortable
Joining governance systems
Engaging in legislative advocacy efforts
Participating in service/ volunteer activities characterized by reciprocity
Challenging unfair and unjust behavior to make a positive difference in the community
Educating and facilitating the civic engagement of others

Please rate your comfort level with the following actions.*
Actively Avoid Not Comfortable Indifferent Comfortable Very Comfortable
Engaging in divergent thinking and risk-taking

Select the best answer.*

	Disagree	Somewhat disagree	Neither agree or disagree	Somewhat agree	Agree
I can synthesize existing ideas and concepts in innovative and creative ways to develop new ways of thinking or working.
I actively seek to improve ways or systems to improve results.

Please rate your comfort level with the following actions.*

	Actively Avoid	Not Comfortable	Indifferent	Comfortable	Very Comfortable
Utilizing basic MS Office tools (Word and PPT)
Utilizing advanced MS Office tools (Excel)
Utilizing social media platforms (Facebook, Intagram)
Utilizing office technology such as the printer, telephone, projector, and web cam

Select the best answer.*

	Disagree	Somewhat disagree	Neither agree or disagree	Somewhat agree	Agree
I attempt to troubleshoot issues that arise with the copier or computer before asking for help.
I attempt to troubleshoot issue that arise with a computer application or software before asking for help.

Now please choose only 5 key words to describe how ‘others’ would describe YOU.*
LoudCaringToughHelpfulAttractiveUnselfishInstinctiveDisagreeableCombativeSincereStrong WilledUnhealthySkilfulLoyalCleverDeterminedOverweightIndependentThoughtfulSuccessfulInventiveGreedyTrustworthyHonestCalmFairHorribleDominatingConfidentChoosyStrategicInnovativeCreativeComplexBusyStrict
Using 20 words or less; please describe what you fear most:*
Should be Empty: