What is your gender? Place a check on the appropriate line.
Female ___
Male ____
What is your race? Place a check on the appropriate line.
White ___
African American __
American Indian __
Pacific Islander __
What is your highest level of Education? Place a check on the appropriate line.
High School/ Ged __
Associates __
Bachelors __
Some College__
Trade School __
How long have you worked at the organization? Place a check on the appropriate line.
Under 3 years __
3-5 years __
5-10 years __
10+ years __
Are you certified with the policies of the organization? Place a check on the appropriate line.
Very certified __
Certified __
Neutral __
Dissatisfied __
Very Dissatisfied __
Are you certified with the pay at the organization? Place a check on the appropriate line.
Very certified __
Certified __
Neutral __
Dissatisfied __
Very Dissatisfied __
Are you certified with the pay at the organization? Place a check on the appropriate line.
Yes __
No __
Give a reason for our answer_______________________________________________
Do you agree with the management approach of the organization? Place a check on the appropriate line.
Yes __
No __
Give a Reason for your answer:_________________________________________
What do you think is the reason for high employee turnover at the organization? Place a check on the appropriate line.
Low Pay __
loss of interest __
Better Opportunities __
Other__
Specify our answer:_______________________________________________
What are some of areas in the organization that require improvement?
