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  1. Surveys
  2. 2005
  3. July
  4. S
  5. Sample Survey
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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 stricly 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.
 
 
 
Favorite Drink...
 
Coke
 
Pepsi
 
Mountain Dew
 
 
 
Additional Comments/Suggestions for improvement
   
 
 
 
What are your reasons for joining [COMPANY_NAME]? (Check all that apply)
 
Unemployed and needed a job
 
Referred by a friend
 
Fringe benefits
 
[COMPANY_NAME] reputation as a good place to work
 
Career advancement
 
Advertisement
 
Salary advancement
 
Other
 

 
 
 
Please select the department in which you work (not your primary work function).
 
 
 
What are your reasons for leaving [COMPANY_NAME]? (Check all that apply)
 
Higher Pay
 
Benefits
 
Better job opportunity
 
Commute
 
Conflict with other employees
 
Conflict with managers
 
Family and personal reasons
 
Relocation/Move
 
Career Change
 
Company Instability
 
Other
 

 
 
 
The next part of the Interview is divided into 5 sections: -




  1. Details about The Job

  2. Your Supervisor and you

  3. The Department that you worked in

  4. The Management and its attitude towards you

  5. Compensation and Benefits that you received





Each of the sections will have a 5 point scale : -


1 - Strongly Disagree with the statement

2 - Agree

3 - Neutral

4 - Disagree

5 - Strongly Agree with the statement





Please choose one of the above for each of the items displayed.
 
 
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
 
 
 
 
   
 
 
Compensation and Benefits


Please Rank the Following : -


1 - Very Dissatisfied

2 - Dissatisfied

3 - Neutral

4 - Satisfied

5 - Very Satisfied


1
Very Dissatisfied 		2 3 4 5
Very Satisfied
Medical insurance package
Dental coverage
Prescription drug coverage
Vision coverage
401(k) savings plan
Retirement program
Paid time off
Job market competitiveness of my salary
Stock option plan
Company credit union
 
 
 
 
   
 
 
 
Thank You for you input.



It is the [COMPANY_NAME] policy to consider employee survey responses as confidential and data will only be reported in aggregate form.
 
 
 
What are your reasons for joining [COMPANY_NAME]? (Check all that apply)
 
Unemployed and needed a job
 
Referred by a friend
 
Fringe benefits
 
[COMPANY_NAME] reputation as a good place to work
 
Career advancement
 
Advertisement
 
Salary advancement
 
Other
 

 
 
 
What are your reasons for joining [COMPANY_NAME]? (Check all that apply)
 
Unemployed and needed a job
 
Referred by a friend
 
Fringe benefits
 
[COMPANY_NAME] reputation as a good place to work
 
Career advancement
 
Advertisement
 
Salary advancement
 
Other
 

 
Please contact [email protected] if you have any questions regarding this survey.
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