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The Job Itself



1
Strongly Disagree
2
Disagree
3
Neutral
4
Agree
5
Strongly Agree
Job was challenging
Skills were effectively used
Job orientation was effective
Work load was reasonable
Sufficient resources were available
Work environment was safe, comfortable and appropriately equipped
 
 
 
   
 
My Supervisor



1
Strongly Disagree
2
Disagree
3
Neutral
4
Agree
5
Strongly Agree
Had knowledge of the job
Had knowledge of supervision
Was open to suggestions
Recognized employees contribution
 
 
 
   
 
The Department



1
Strongly Disagree
2
Disagree
3
Neutral
4
Agree
5
Strongly Agree
Had good synergy
Had adequate equipment
Was adequately staffed
Was efficient
 
 
 
   
 
The Management



1
Strongly Disagree
2
Disagree
3
Neutral
4
Agree
5
Strongly Agree
Gave fair and equal treatment
Was available to discuss job related issues
Welcomed suggestions and encouraged feedback
Maintained consistent policies and practices
Provided recognition for achievements
Encouraged cooperation/collegiality
Provided development opportunities
 
 
 
   
 

Is your home
 
a single family house
 
a two family house
 
an apartment
 
a mobile home
 
Other
 
 
 
Are you (Check all that apply)
 
married
 
divorced
 
widowed
 
separated
 
single
 
step parent

 
 
Indicate total household income:
 
under $25,000
 
$25,000 - $29,999
 
$30,000 - $34,999
 
$35,000 - $39,999
 
$40,000 - $49,999
 
$50,000 - $59,999
 
$60,000 - $84,999
 
Over $85,000
 
 
 
The amount of work I am expected to do on my job is reasonable.
 
Strongly Disagree
 
Disagree
 
Neutral
 
Agree
 
Strongly Agree
 
N/A
 
 
I am satisfied with the priorities and direction of my department.
 
Strongly Disagree
 
Disagree
 
Neutral
 
Agree
 
Strongly Agree
 
N/A
 
 
I have adequate information available which enables me to do my job well.
 
Strongly Disagree
 
Disagree
 
Neutral
 
Agree
 
Strongly Agree
 
N/A
 
 
We operate in a cost-efficient way in my department.
 
Strongly Disagree
 
Disagree
 
Neutral
 
Agree
 
Strongly Agree
 
N/A
 
 
I understand the day-to-day goals of my department.
 
Strongly Disagree
 
Disagree
 
Neutral
 
Agree
 
Strongly Agree
 
N/A
 
 
Diverse perspectives are valued and encouraged within the department.
 
Strongly Disagree
 
Disagree
 
Neutral
 
Agree
 
Strongly Agree
 
N/A
 
 
Considering everything, how satisfied are you with your job?
 
Very Dissatisfied
 
Somewhat Dissatisfied
 
Neutral
 
Somewhat Satisfied
 
Very Satisfied
 
Not Sure
 
 
My work group has a climate in which diverse perspectives are valued.
 
Strongly Disagree
 
Disagree
 
Neutral
 
Agree
 
Strongly Agree
 
 
The physical working conditions(e.g., ventilation, space, cleanliness) are very good.
 
Strongly Disagree
 
Disagree
 
Neutral
 
Agree
 
Strongly Agree
 
N/A
 
 
Individual differences are respected here(e.g., gender, race, educational background, etc.)
 
Strongly Disagree
 
Disagree
 
Neutral
 
Agree
 
Strongly Agree
 
N/A
 
 
What is your approximate age?
 
18 - 24
 
25 - 34
 
35 - 44
 
45 - 54
 
55 - 64
 
65 and over
 
 
What was the last grade you completed in school?
 
Some high school
 
High school graduate
 
Some college
 
College graduate
 
Postgraduate/professional
 
Other
 
 
 
Please indicate the number of children in your household under the age of 18.
 
None
 
One
 
Two
 
Three
 
Four or more
 
 
Including yourself, how many persons are in your household?
 
One
 
Two
 
Three
 
Four
 
Five or more
 
 
What is your current work status?
 
Work outside home full time
 
Work outside home part time
 
Do not work outside home
 
Other
 
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