CONFIDENTIAL

Organization ABC
DEMONSTRATION WORK CLIMATE SURVEY


ALL questions require answers. The form will not submit until all questions are answered.
Click TAB to advance from field to field.
What is your function in ABC? Please left click your mouse in the circle to the left of the appropriate function.
Management - VP, Director, Manager, or Specialist of a Program or Function (e.g., Recruiting, Development).
Direct Service Provider - Area Supervisor, Case Worker
Support Staff - Administrative Assistant, Secretary, Clerk.
To what extent do you agree or disagree with each statement below?   Please left click your mouse in the circle to the left of the number that best applies to each statement.  
1=Strongly Disagree  2=Disagree   3=Neither Agree Nor Disagree   4=Agree  5=Strongly Agree  
Q1.I know what is expected of me at work.
1 2 3 4 5
Q2.I have the equipment and information I need to do my work effectively.
1 2 3 4 5
Q3.The organization uses my time and talents well.
1 2 3 4 5
Q4.I receive appropriate recognition and appreciation from others.
1 2 3 4 5
1=Strongly Disagree  2=Disagree   3=Neither Agree Nor Disagree   4=Agree  5=Strongly Agree  
Q5.I feel respected and my opinions seem to count.
1 2 3 4 5
Q6.My coworkers take pride in the quality of their work.
1 2 3 4 5
Q7.The people I work with cooperate and work as a team.
1 2 3 4 5
Q8.I am committed to our agency's mission and vision.
1 2 3 4 5
1=Strongly Disagree  2=Disagree   3=Neither Agree Nor Disagree   4=Agree  5=Strongly Agree  
Q 9. We have the measures and processes we need to help us determine whether our programs and services are satisfying the people we serve.
1 2 3 4 5
Q10.We have a climate where everyone communicates openly.
1 2 3 4 5
Q11.I am encouraged by my supervisor and ABC management for ideas that may improve programs and services.
1 2 3 4 5
Q12.I have opportunities at work to learn and grow.
1 2 3 4 5
Q13.The process used to evaluate my performance is appropriate and fair.
1 2 3 4 5
Q14.I feel confident in recommending a friend to work here.
1 2 3 4 5
Q15. The 3 greatest strengths of ABC are:

A.
B.
C.
Q 16.The 3 things ABC could do to help me do my best work are:

A.
B.
C.
STOP!  Please review to determine if you have answered all questions.  The survey program will automatically prevent the submission of partially completed surveys.  If you feel that you cannot complete the survey to your satisfaction at this time, close your browser and begin anew at your convenience before the close of business on 00/00/00.

After pressing the "Submit" button, if your form is complete (no further questions requiring attention), a screen will appear stating that your submission has been received and is being processed.  Once this screen appears, please, DO NOT press the button again!  
Thank you for submitting this survey.

This survey is provided by:

The Alliance for Effective Organizations, Inc.
712 Germantown Pike
Lafayette Hill, PA 19444
Tel:  215.233.0445  Fax:  215.233.1814  E-Mail:  info@aeoinc.com

Copyright © Nov 2003-2005 End-Vision It!  All Rights Reserved.
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