[SURVEY SAMPLE] REVIEW YOUR EMPLOYER – Best Companies for Women

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1. Which employer are you reviewing?* This field is required.
2
To which gender identity do you most identify?* This field is required.
Female
Male
Transgender Female
Transgender Male
Gender Variant/Non-Conforming
Not Listed
Prefer Not to Answer
3
What employer location are you reviewing?* This field is required.
4
What's your overall level of job satisfaction?* This field is required.
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2
3
4
5
Very Unsatisfied
Very Satisfied
5
Do you believe women and men are treated equally here?* This field is required.
YESNO
6
Would you recommend this employer to other women?* This field is required.
YESNO
7
What's the most important thing that could be done to make you stay?
Please Select
Please Select
Not much, it's a great place to work
Promote more women into leadership positions
Improve work-life balance and related policies
Improve my benefits
Improve my compensation
OPTIONAL: Other (Please explain.)
8
Do you think work-life balance is supported in the following ways?* This field is required.
Hours
Culture
Policies
None apply
9
How much flexibility do you think exists?* This field is required.
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2
3
4
5
Very Inflexible
Very Flexible
10
What would you tell another woman about working here?* This field is required.Please share your thoughts in at least 10 words.
Huge
Large
Normal
Small
Ok
Ok
11
How supportive is your manager?* This field is required.
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2
3
4
5
Not Supportive
Very Supportive
12
Do you think your CEO supports gender diversity?* This field is required.
Yes
No
Unsure
13
Are any of the following benefits offered?* This field is required.
Parental leave benefits
Fertility benefits
401k or pension / retirement benefits
Childcare benefits
Healthcare benefits
None
14
Is paid parental leave offered, and if so, how much?* This field is required.
Yes
No / Unsure
15
Paid, in weeks (Enter a number between 0 and 52)
Unpaid, in weeks (Enter a number between 0 and 52)
16
Gender DiscriminationPlease choose the appropriate answer to indicate the extent to which you agree to the statements.
Strongly Agree (SA)
Agree (A)
Neutral (N)
Disagree (DA)
Strongly Disagree (SDA)
1. I have experienced gender discrimination in the workplace.
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2. My supervisor does not consider gender in delegating job assignment.
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3. My gender does influence my profession.
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4. Peers would treat me differently because of my gender.
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1. I have experienced gender discrimination in the workplace.
2. My supervisor does not consider gender in delegating job assignment.
3. My gender does influence my profession.
4. Peers would treat me differently because of my gender.
Strongly Agree (SA)
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Agree (A)
Row 0, Column 1
Neutral (N)
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Disagree (DA)
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Strongly Disagree (SDA)
Row 0, Column 4
Strongly Agree (SA)
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Agree (A)
Row 1, Column 1
Neutral (N)
Row 1, Column 2
Disagree (DA)
Row 1, Column 3
Strongly Disagree (SDA)
Row 1, Column 4
Strongly Agree (SA)
Row 2, Column 0
Agree (A)
Row 2, Column 1
Neutral (N)
Row 2, Column 2
Disagree (DA)
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Strongly Disagree (SDA)
Row 2, Column 4
Strongly Agree (SA)
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Agree (A)
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Neutral (N)
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Disagree (DA)
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Strongly Disagree (SDA)
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Salary
Strongly Agree (SA)
Agree (A)
Neutral (N)
Disagree (DA)
Strongly Disagree (SDA)
1. There are salary gaps among the same level in my organization.
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2. I have been unfairly denied a salary increase in my organization.
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3. I am satisfied with my current salary.
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1. There are salary gaps among the same level in my organization.
2. I have been unfairly denied a salary increase in my organization.
3. I am satisfied with my current salary.
Strongly Agree (SA)
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Agree (A)
Row 0, Column 1
Neutral (N)
Row 0, Column 2
Disagree (DA)
Row 0, Column 3
Strongly Disagree (SDA)
Row 0, Column 4
Strongly Agree (SA)
Row 1, Column 0
Agree (A)
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Neutral (N)
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Disagree (DA)
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Strongly Disagree (SDA)
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Strongly Agree (SA)
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Agree (A)
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Neutral (N)
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Disagree (DA)
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Strongly Disagree (SDA)
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