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| Number of children delivered: |
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| Are you employed outside the home? |
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| If employed outside the home; what is your approximate income? |
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| What is your approximate annual household income: |
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| Are you (Check all that apply) |
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| Indicate total household income: |
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| How flexible is the company with respect to your family responsibilities? |
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| I have a clear path for career advancement? |
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There are opportunities available for me to develop new skills.
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I have the opportunity for career development within [Company].
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Overall, how satisfied are you with your career development within [company]?
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