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Hello:
You are invited to participate in our survey [Project Description Here]. In this survey, approximately [Approximate Respondents] people will be asked to complete a survey that asks questions about [General Survey Process]. It will take approximately [Approximate Time] minutes to complete the questionnaire.

Your participation in this study is completely voluntary. There are no foreseeable risks associated with this project. However, if you feel uncomfortable answering any questions, you can withdraw from the survey at any point. It is very important for us to learn your opinions.

Your survey responses will be strictly confidential and data from this research will be reported only in the aggregate. Your information will be coded and will remain confidential. If you have questions at any time about the survey or the procedures, you may contact [Name of Survey Researcher] at [Phone Number] or by email at the email address specified below.

Thank you very much for your time and support. Please start with the survey now by clicking on the Continue button below.

 
 
 
 
What is your gender?
 
Male
 
Female
 
 
 
What is your marital status?
 
Single (Never married)
 
Married
 
Domestic partnership
 
Widowed
 
Divorced
 
Separated
 
Don’t know
 
 
 
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 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 category best describes your annual income?
 
Under $15,000
 
$15,000 - $29,999
 
$30,000 - $44,999
 
$45,000 - $59,999
 
$60,000 - $74,999
 
$75,000 - $89,999
 
$90,000 - $104,999
 
$105,000 - $119,999
 
$120,000 or more
 
Prefer not to answer
 
 
 
How many children do you have?
 
no children
 
1 child
 
2 children
 
3 children
 
more than 4 children
 
 
 
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 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
 
 
 
The company clearly communicates its goals and strategies to me?
 
Strongly disagree
 
Somewhat disagree
 
Don't agree or disagree
 
Somewhat agree
 
Strongly agree
 
 
 
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
 
 
 
I have a clear path for career advancement?
 
Strongly disagree
 
Somewhat disagree
 
Neither agree nor disagree
 
Somewhat agree
 
Strongly agree
 
 
 
Rate the amount of work you did
 
Almost none
 
What was assigned
 
More than just what was assigned
 
 
 
Descriptive / Spacer Text Here
 
 
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