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1) AGE :
11) Are the benefits that your company is extending to you is sufficient
?
(a) FULLY SUFFICIENT
(b) SUFFICIENT
(c) INSUFFICIENT
12) How do you view this job?
(a) CHALLENGING
(b) RESPONSIBLE
(c) MOTIVATING
(d) SECURED
13) Are you satisfied with the present position in your company?
(a) HIGHLY SATISFIED (b) SATISFIED
(c) DISSATISFIED
(d) HIGHLY DISSATISFIED
17) How satisfied are you with your team-spirit in your work
environment?
(a) HIGHLY SATISFIED (b) SATISFIED
(c) DISSATISFIED
(d) HIGHLY DISSATISFIED
18) How satisfied are you with your overall job security?
(a) HIGHLY SATISFIED (b) SATISFIED
(c) DISSATISFIED
(d) HIGHLY DISSATISFIED
PART I
GENERAL INFORMATION
Occupation: _____________________________________________________________
How long have you worked for this company? _________________________________
What previous positions have you held with the company? ________________________
_______________________________________________________________________
_______________________________________________________________________
__
What is your job title? _____________________________________________________
How long have you held your current position? _________________________________
Briefly describe your work responsibilities (as you would on a resume):
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_____
PART II
1 2 3 4 5
not satisfied somewhat extremely
at all satisfied satisfied
Using the scale shown above, rate your level of satisfaction with the following aspects of
your job.
WORK RELATIONSHIPS
_____ Relationships with your co-workers
_____ Relationship(s) with your supervisor(s)
_____ Relationships with your subordinates (if applicable)
WORK ACTIVITIES
_____ Variety of job responsibilities
_____ Degree of independence associated with your work roles
_____ Adequate opportunity for periodic changes in duties