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Name
   
 
 
 
Designation
   
 
 
 
Email Address
   
 
 
 
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 favorite hobby or interest?
 
Auto racing
 
Biking
 
Boating
 
Bowling
 
Camping
 
Crafts
 
Dancing
 
Fine Arts
 
Fishing
 
Gambling
 
Gardening
 
Hiking
 
Hunting
 
Horseback riding
 
Kayaking
 
Martial Arts
 
Music
 
Photography
 
Reading
 
Sports
 
Travel
 
Other
 
 
 
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 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
 
 
 
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 would you describe yourself?
 
Democratic
 
Republican
 
Independent
 
None of the above
 
 
 
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
 
 
 
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
 
 
 
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
 
 
 
Which of the following best describes your reason for taking the course?
 
Major/minor requirement
 
Major elective course
 
General education
 
University elective
 
 
 
Rate the amount of work you did
 
Almost none
 
What was assigned
 
More than just what was assigned
 
 
 
Could you get clear answers to your questions from the instructor?
 
Never
 
Sometimes
 
Usually
 
Most of the time
 
Always
 
 
 
Was the instructor considerate to you?
 
Never
 
Sometimes
 
Usually
 
Most of the time
 
Always