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What is your gender?
 
Male
 
Female
 
 
 
What is your age?
 
Younger than 18
 
18 - 24
 
25 - 34
 
35 - 44
 
45 - 54
 
55 - 64
 
65 or older
 
Prefer not to answer
 
 
 
What is your marital status?
 
Single (Never married)
 
Married
 
Domestic partnership
 
Widowed
 
Divorced
 
Separated
 
Don’t know
 
 
 
How many children do you have?
 
no children
 
1 child
 
2 children
 
3 children
 
more than 4 children
 
 
 
What is the highest level of education you have achieved?
 
Less than high school degree
 
High school degree or equivalent (e.g. GED)
 
Some college but no degree
 
Associate degree (e.g. AA, AS)
 
Bachelor's degree (e.g. BA, AB, BS)
 
Master's degree (e.g. MA, MS, MBA)
 
Professional degree (e.g. MD, DDS, JD)
 
Doctorate degree (e.g. PhD)
 
 
 
Which of the following categories best describes the industry you work in?
 
Automotive
 
Advertising
 
Consulting Services
 
Education
 
Entertainment
 
Financial Services
 
Government Services
 
Healthcare
 
Human Resources
 
Information Technology
 
Marketing/Sales
 
Non-Profit
 
Pharmaceuticals
 
Public Relations
 
Technical Services
 
Travel
 
Other
 
 
 
How well do you believe your manager lives by your company's ethic?
 
Extremely well
 
Very well
 
Sometimes does, sometimes doesn't
 
Not very well
 
Doesn't abide by philosophy at all
 
 
 
What are your reasons for joining our company? (Check all that apply)
 
Unemployed and needed a job
 
Referred by a friend
 
Fringe benefits
 
Reputation as a good place to work
 
Career advancement
 
Advertisement
 
Salary advancement
 
Other

 
 
 
If you have ever offered suggestions to management, how satisfied were you with the response?
 
Never offered a suggestion
 
Not at all satisfied
 
Not very satisfied
 
Somewhat satisfied
 
Very satisfied
 
 
 
How long have you been working for the company?
 
Less than a year
 
1-2 years
 
3-5 years
 
6-10 years
 
More than 10 years
 
 
 
What is your job function?
 
Non-supervisory Staff
 
Supervisor
 
Functional Manager
 
Department Manager
 
Senior Management/Director/Vice President
 
Senior Executive/Chief Officer/Executive Vice President
 
 
 
Overall, how satisfied are you with the company you work for?
 
Extremely Dissatisfied
 
Very Dissatisfied
 
Neither Satisfied nor Dissatisfied
 
Very Satisfied
 
Extremely Satisfied
 
 
 
Which of the following best describes the department you work in?
 
Customer Service
 
Finance/Accounting
 
Information Systems
 
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
 
 
 
Do you feel that employees are recognized as individuals?
 
Always
 
Usually
 
Sometimes
 
Rarely
 
Never
 
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 motivated are you to see the company succeed?
 
Very motivated
 
Somewhat motivated
 
Not very motivated
 
Not at all motivated
 
Not sure
 
 
 
How flexible is the company with respect to your family responsibilities?
 
Very inflexible
 
Somewhat inflexible
 
Neither
 
Somewhat flexible
 
Very flexible
 
 
 
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

 
 
 
The company clearly communicates its goals and strategies to me?
 
Strongly disagree
 
Somewhat disagree
 
Neither agree nor disagree
 
Somewhat agree
 
Strongly agree
 
 
 
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
 
 
 
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