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Which of the following best describes the department you work in?
 
Customer Service
 
Finance/Accounting
 
MIS
 
Sales/Marketing
 
Corporate Marketing
 
Human Resources
 
 
 
Which of the following best describes your position here?
 
Clerical
 
Technician
 
Managerial
 
Accounting
 
Project Management
 
Other
 
 
 
How long have you worked at (company)?
 
Less than 6 months
 
6 months - 1 year
 
1-2 years
 
3-5 years
 
More than 5 years
 
 
 
Overall how satisfied are you with your position at this company?
 
Very dissatisfied
 
Somewhat dissatisfied
 
Not satisfied or dissatisfied
 
Somewhat Satisfied
 
Very satisfied
 
 
 
Please indicate your level of agreement with each of the following statements.
 
 
 
Do you feel that employees are recognized as individuals?
 
Always
 
Usually
 
Sometimes
 
Rarely
 
Never
 
Not sure
 
 
 
How motivated are you to see the company succeed?
 
Very motivated
 
Somewhat motivated
 
Not very motivated
 
Not at all motivated
 
Not sure
 
 
 
The company clearly communicates its goals and strategies to me.
 
Strongly disagree
 
Somewhat disagree
 
Don't agree or disagree
 
Somewhat agree
 
Strongly agree
 
 
 
How flexible is the company with respect to your family responsibilities?
 
Very inflexible
 
Somewhat inflexible
 
Neither
 
Somewhat flexible
 
Very flexible
 
 
 
Do you take part in your company's flextime program?
 
Yes
 
No
 
 
 
Would you refer a friend to apply for a job at this company?
 
Definitely
 
Probably
 
Not sure
 
Probably not
 
Definitely not
 
 
 
Have you ever observed or experienced any of the following forms of discrimination or harassment at this company?
 
Racial discrimination
 
Sexual harassment
 
Age discrimination
 
Gender discrimination
 
Sexual orientation discrimination
 
No, none of the above have been observed or experienced
 
 
 
Which of the following describes the variety of tasks required by your position?
 
Too many
 
Enough
 
Not enough
 
 
 
I receive enough opportunity to interact with other employees on a formal level.

 
Strongly disagree
 
Somewhat disagree
 
Neither agree nor disagree
 
Somewhat agree
 
Strongly agree
 
 
 
How would you rate (Company) on each of the following?
 
 
 
I have a clear path for career advancement.


 
Strongly disagree
 
Somewhat disagree
 
Neither agree nor disagree
 
Somewhat agree
 
Strongly agree
 
 
 
My job requirements are clear




 
Strongly disagree
 
Somewhat disagree
 
Neither agree nor disagree
 
Somewhat agree
 
Strongly agree
 
 
How would you rate your manager in each of the following areas? Please assign a rating on a scale from 1 to 5, where 1 represents "Poor" and 5 represents "Excellent".
Poor    Average    Good    Very Good    Excellent   
Communication
Planning and organizing
Directing and coordinating
Job/Technical knowledge
Interpersonal relationship