Identification#. Please add below the number provided in this email. It is critically important this number be included, otherwise the survey will not be tabulated correctly.
ID #
Unsuccessful Partially Successful Successful Very Successful Its Peers Market Share Brand/Reputation Built Return on Investment Other Metric
Target Market Share Target ROI
Still in Existence Acquired/Merged Went Through an IPO No Longer in Existence
3. In absolute terms, how do you rate the performance of the CEO? Please assign a rating on a scale from 1 to 5, where 1 represents "Unsuccessful" and 5 represents "Very Successful".
1 2 3 4 5 Performance of CEO
Please assign a rating on a scale from 1 to 5, where 1 represents "Unsuccessful vs. Peers " and 5 represents "Very Successful vs. Peers".
Please assign a rating on a scale from 1 to 5, where 1 represents "Minor Impact" and 5 represents "Very Significant Impact".
1 2 3 4 5 Impact of CEO
Please assign a rating on a scale from 1 to 5, where 1 represents "Strong No" and 5 represents "Strong Yes".
1 2 3 4 5 The relationship is positive.
1 2 3 4 5 The relationship is highly interactive. The relationship is positive. The relationship is value-adding.
Strongest Three Characteristics Weakest Three Leadership Skills Industry Knowledge Industry Contacts Entrepreneurial Skills Traditional 'Corporate' Skills Management Skills Top Education Ethics/Integrity Charisma Visioning Skills Analytical Skills Individual Social and Business Interaction Execution/Operational Ability Ability to Attract Top Client Fund-raising Capabilities
Intelligence (IQ) Emotional Intelligence (Adaptability/Street smarts) Experience
9. Regarding the CEO in question, would you hire that individual again to run another venture-backed company?
Please assign a rating on a scale from 1 to 5, where 1 represents "Would NOT Hire Again" and 5 represents "Would Hire Again".
1 2 3 4 5 CEO Hiring
Willing to forego any short or long term advantage to do what is right. Willing to act on certain "gray areas" to his/his company's advantage. Play within the defined rules, but aggressively pursue "gray area" advantages. Will do whatever it takes to succeed, based on assumption that all actions taken will be kept confidential.
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Name Firm Name Address (Optional) Email Address