sample questionnaire

Punch and column number examples:

A - Rating scale
B - Ranking
C - Open-end
D - Checking boxes
E - Yes/No box
F&G - Different Questions on the same line

Sample Questionnaire

A. Listed below are some items that are related to your satisfaction. Thinking only about the last 2 years of your career, please rate the company's performance using a 1 to 5 scale; where 1 means the company did not meet your expectations, and 5 means the company far exceeded your expectations. (Circle the appropriate number below, if it is not applicable then leave blank)

                                                          Far                     Partially  Did Not  

    Items:                                             Exceeded  Exceeded   Met      Met      Meet




1)  Ongoing performance feedback............................5........4........3........2........1   (6)


2)  Communicate with immediate manager......................5........4........3........2........1   (7)


3)  Involvement with decisions..............................5........4........3........2........1   (8)


4)  Recognition.............................................5........4........3........2........1   (9)


5)  Opportunity for advancement/mobility....................5........4........3........2........1  (10)


6)  Opportunity for professional advancement................5........4........3........2........1  (11)


7)  Manageable stress level.................................5........4........3........2........1  (12)


8)  Fair treatment..........................................5........4........3........2........1  (13)


9)  Job makes good use of skills and abilities..............5........4........3........2........1  (14)


10) Training................................................5........4........3........2........1  (15)


 
B. For items 1 - 10 above, please rank the top 2 - 3 factors which most strongly influenced your decision to 
   stay with the company, by writing in the item number: 



      Primary (1st) ________      Secondary (2nd) _________      Tertiary (3rd) _________  
                     (16-17)                          (18-19)                       (20-21)


  
C. Please provide additional feedback for the company: 

                                                                                                (22)
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