Survey Formats – Sample Questions

<!-- SAMPLE SURVEY begin --><!-- [et_pb_line_break_holder] --> <h4 class="background">Demographics:</h4><!-- [et_pb_line_break_holder] --> <p class="note">(Collect any kind or number of demographics that you require.)</p><!-- [et_pb_line_break_holder] --> <table class="sample sample-formats"><!-- [et_pb_line_break_holder] --> <tr><!-- [et_pb_line_break_holder] --> <td class="survey_number">A</td><!-- [et_pb_line_break_holder] --> <td class="survey_question"><a name="B1"></a>Are you:</td><!-- [et_pb_line_break_holder] --> </tr><!-- [et_pb_line_break_holder] --> <tr><!-- [et_pb_line_break_holder] --> <td></td><!-- [et_pb_line_break_holder] --> <td><input type="radio" value="1" name="V_A1_AreYo" /> Male</td><!-- [et_pb_line_break_holder] --> </tr><!-- [et_pb_line_break_holder] --> <tr><!-- [et_pb_line_break_holder] --> <td></td><!-- [et_pb_line_break_holder] --> <td><input type="radio" value="2" name="V_A1_AreYo" /> Female</td><!-- [et_pb_line_break_holder] --> </tr><!-- [et_pb_line_break_holder] --> </table><!-- [et_pb_line_break_holder] --> <p> </p><!-- [et_pb_line_break_holder] --> <table class="sample sample-formats"><!-- [et_pb_line_break_holder] --> <tr><!-- [et_pb_line_break_holder] --> <td class="survey_number">B</td><!-- [et_pb_line_break_holder] --> <td class="survey_question"><a name="B2"></a>What State do you live in?</td><!-- [et_pb_line_break_holder] --> </tr><!-- [et_pb_line_break_holder] --> <tr><!-- [et_pb_line_break_holder] --> <td class="survey_number"></td><!-- [et_pb_line_break_holder] --> <td><!-- [et_pb_line_break_holder] --> <input type="hidden" value="5" name="I_A2_WhatS" /><!-- [et_pb_line_break_holder] --> <select size="1" name="V_A2_WhatS"><!-- [et_pb_line_break_holder] --> <option value="" selected="selected">- Select One -</option><!-- [et_pb_line_break_holder] --> <option value="1">Alabama</option><!-- [et_pb_line_break_holder] --> <option value="2">Alaska</option><!-- [et_pb_line_break_holder] --> <option value="3">Arizona</option><!-- [et_pb_line_break_holder] --> <option value="4">Arkansas</option><!-- [et_pb_line_break_holder] --> <option value="5">California</option><!-- [et_pb_line_break_holder] --> <option value="6">Colorado</option><!-- [et_pb_line_break_holder] --> <option value="7">Connecticut</option><!-- [et_pb_line_break_holder] --> <option value="8">Delaware</option><!-- [et_pb_line_break_holder] --> <option value="9">District of Columbia</option><!-- [et_pb_line_break_holder] --> <option value="10">Florida</option><!-- [et_pb_line_break_holder] --> <option value="11">Georgia</option><!-- [et_pb_line_break_holder] --> <option value="12">Hawaii</option><!-- [et_pb_line_break_holder] --> <option value="13">Idaho</option><!-- [et_pb_line_break_holder] --> <option value="14">Illinois</option><!-- [et_pb_line_break_holder] --> <option value="15">Indiana</option><!-- [et_pb_line_break_holder] --> <option value="16">Iowa</option><!-- [et_pb_line_break_holder] --> <option value="17">Kansas</option><!-- [et_pb_line_break_holder] --> <option value="18">Kentucky</option><!-- [et_pb_line_break_holder] --> <option value="19">Louisiana</option><!-- [et_pb_line_break_holder] --> <option value="20">Maine</option><!-- [et_pb_line_break_holder] --> <option value="21">Maryland</option><!-- [et_pb_line_break_holder] --> <option value="22">Massachusetts</option><!-- [et_pb_line_break_holder] --> <option value="23">Michigan</option><!-- [et_pb_line_break_holder] --> <option value="24">Minnesota</option><!-- [et_pb_line_break_holder] --> <option value="25">Mississippi</option><!-- [et_pb_line_break_holder] --> <option value="26">Missouri</option><!-- [et_pb_line_break_holder] --> <option value="27">Montana</option><!-- [et_pb_line_break_holder] --> <option value="28">Nebraska</option><!-- [et_pb_line_break_holder] --> <option value="29">Nevada</option><!-- [et_pb_line_break_holder] --> <option value="30">New Hampshire</option><!-- [et_pb_line_break_holder] --> <option value="31">New Jersey</option><!-- [et_pb_line_break_holder] --> <option value="32">New Mexico</option><!-- [et_pb_line_break_holder] --> <option value="33">New York</option><!-- [et_pb_line_break_holder] --> <option value="34">North Carolina</option><!-- [et_pb_line_break_holder] --> <option value="35">North Dakota</option><!-- [et_pb_line_break_holder] --> <option value="36">Ohio</option><!-- [et_pb_line_break_holder] --> <option value="37">Oklahoma</option><!-- [et_pb_line_break_holder] --> <option value="38">Oregon</option><!-- [et_pb_line_break_holder] --> <option value="39">Pennsylvania</option><!-- [et_pb_line_break_holder] --> <option value="40">Rhode Island</option><!-- [et_pb_line_break_holder] --> <option value="41">South Carolina</option><!-- [et_pb_line_break_holder] --> <option value="42">South Dakota</option><!-- [et_pb_line_break_holder] --> <option value="43">Tennessee</option><!-- [et_pb_line_break_holder] --> <option value="44">Texas</option><!-- [et_pb_line_break_holder] --> <option value="45">Utah</option><!-- [et_pb_line_break_holder] --> <option value="46">Vermont</option><!-- [et_pb_line_break_holder] --> <option value="47">Virginia</option><!-- [et_pb_line_break_holder] --> <option value="48">Washington</option><!-- [et_pb_line_break_holder] --> <option value="49">West Virginia</option><!-- [et_pb_line_break_holder] --> <option value="50">Wisconsin</option><!-- [et_pb_line_break_holder] --> <option value="51">Wyoming</option><!-- [et_pb_line_break_holder] --> </select></td><!-- [et_pb_line_break_holder] --> </tr></table><!-- [et_pb_line_break_holder] --> <p> </p><!-- [et_pb_line_break_holder] --> <table class="sample sample-formats"><!-- [et_pb_line_break_holder] --> <tr><!-- [et_pb_line_break_holder] --> <td class="survey_number">C</td><!-- [et_pb_line_break_holder] --> <td class="survey_question"><a name="B3"></a>What is your age?<br /><span class="survey_type">(Question Type: Customized Drop-Down List)</span></td><!-- [et_pb_line_break_holder] --> </tr><!-- [et_pb_line_break_holder] --> <tr><!-- [et_pb_line_break_holder] --> <td class="survey_number"></td><!-- [et_pb_line_break_holder] --> <td><!-- [et_pb_line_break_holder] --> <input type="hidden" value="5" name="I_A3_WhatI" /><!-- [et_pb_line_break_holder] --> <select size="1" name="V_A3_WhatI"><!-- [et_pb_line_break_holder] --> <option value="" selected="selected">- Select One -</option><!-- [et_pb_line_break_holder] --> <option value="1">Under 25</option><!-- [et_pb_line_break_holder] --> <option value="2">25 - 34</option><!-- [et_pb_line_break_holder] --> <option value="3">35 - 44</option><!-- [et_pb_line_break_holder] --> <option value="4">45 - 54</option><!-- [et_pb_line_break_holder] --> <option value="5">55 - 64</option><!-- [et_pb_line_break_holder] --> <option value="6">65+</option><!-- [et_pb_line_break_holder] --> </select><!-- [et_pb_line_break_holder] --> </td><!-- [et_pb_line_break_holder] --> </tr><!-- [et_pb_line_break_holder] --> </table><!-- [et_pb_line_break_holder] --> <p> </p><!-- [et_pb_line_break_holder] --> <table class="sample sample-formats"><!-- [et_pb_line_break_holder] --> <tr><!-- [et_pb_line_break_holder] --> <td class="survey_number">D</td><!-- [et_pb_line_break_holder] --> <td class="survey_question"><a name="B4"></a>How long have you been employed by ABC Company?</td><!-- [et_pb_line_break_holder] --> </tr><!-- [et_pb_line_break_holder] --> <tr><!-- [et_pb_line_break_holder] --> <td rowspan="5"></td><!-- [et_pb_line_break_holder] --> <td><input type="radio" value="1" name="V_A6_HowLo" /> Less than 1 year</td><!-- [et_pb_line_break_holder] --> </tr><!-- [et_pb_line_break_holder] --> <tr><!-- [et_pb_line_break_holder] --> <td><input type="radio" value="2" name="V_A6_HowLo" /> 1 - 2 years</td><!-- [et_pb_line_break_holder] --> </tr><!-- [et_pb_line_break_holder] --> <tr><!-- [et_pb_line_break_holder] --> <td><input type="radio" value="3" name="V_A6_HowLo" /> 3 - 4 years</td><!-- [et_pb_line_break_holder] --> </tr><!-- [et_pb_line_break_holder] --> <tr><!-- [et_pb_line_break_holder] --> <td><input type="radio" value="4" name="V_A6_HowLo" /> 5 - 6 years</td><!-- [et_pb_line_break_holder] --> </tr><!-- [et_pb_line_break_holder] --> <tr><!-- [et_pb_line_break_holder] --> <td><input type="radio" value="5" name="V_A6_HowLo" /> 6+ years</td><!-- [et_pb_line_break_holder] --> </tr><!-- [et_pb_line_break_holder] --> </table><!-- [et_pb_line_break_holder] --> <p> </p><!-- [et_pb_line_break_holder] --> <h4 class="background">Survey Questions:</h4><!-- [et_pb_line_break_holder] --> <p class="note">(Ask any number of questions in any format.)</p><!-- [et_pb_line_break_holder] --> <table class="sample sample-formats"><!-- [et_pb_line_break_holder] --> <tr><!-- [et_pb_line_break_holder] --> <td class="survey_number">1.</td><!-- [et_pb_line_break_holder] --> <td class="survey_question"><a name="B5"></a>I have a good understanding of the duties/responsibilities of my job.<br /><span class="survey_type">(Question Type: Choose One)</span></td><!-- [et_pb_line_break_holder] --> </tr><!-- [et_pb_line_break_holder] --> <tr><!-- [et_pb_line_break_holder] --> <td rowspan="5"></td><!-- [et_pb_line_break_holder] --> <td><input type="radio" value="0" name="V_A4_IHave" /> Strongly Agree</td><!-- [et_pb_line_break_holder] --> </tr><!-- [et_pb_line_break_holder] --> <tr><!-- [et_pb_line_break_holder] --> <td><input type="radio" value="1" name="V_A4_IHave" /> Agree</td><!-- [et_pb_line_break_holder] --> </tr><!-- [et_pb_line_break_holder] --> <tr><!-- [et_pb_line_break_holder] --> <td><input type="radio" value="2" name="V_A4_IHave" /> Neutral</td><!-- [et_pb_line_break_holder] --> </tr><!-- [et_pb_line_break_holder] --> <tr><!-- [et_pb_line_break_holder] --> <td><input type="radio" value="3" name="V_A4_IHave" /> Disagree</td><!-- [et_pb_line_break_holder] --> </tr><!-- [et_pb_line_break_holder] --> <tr><!-- [et_pb_line_break_holder] --> <td><input type="radio" value="4" name="V_A4_IHave" /> Strongly Disagree</td><!-- [et_pb_line_break_holder] --> </tr><!-- [et_pb_line_break_holder] --> </table><!-- [et_pb_line_break_holder] --> <p> </p><!-- [et_pb_line_break_holder] --> <table class="sample sample-formats"><!-- [et_pb_line_break_holder] --> <tr><!-- [et_pb_line_break_holder] --> <td class="survey_number">2.</td><!-- [et_pb_line_break_holder] --> <td class="survey_question"><a name="B6"></a>I would describe ABC Company's management style as:<br /><span class="survey_type">(Question Type: Choose All That Apply)</span></td><!-- [et_pb_line_break_holder] --> </tr><!-- [et_pb_line_break_holder] --> <tr><!-- [et_pb_line_break_holder] --> <td rowspan="10"></td> <!-- [et_pb_line_break_holder] --> <td><input type="checkbox" value="1" name="V_A5_IWoul" /> Friendly</td><!-- [et_pb_line_break_holder] --> </tr><!-- [et_pb_line_break_holder] --> <tr><!-- [et_pb_line_break_holder] --> <td><input type="checkbox" value="1" name="V_A5_IWou2" /> Intimidating</td><!-- [et_pb_line_break_holder] --> </tr><!-- [et_pb_line_break_holder] --> <tr><!-- [et_pb_line_break_holder] --> <td><input type="checkbox" value="1" name="V_A5_IWou3" /> Fair</td><!-- [et_pb_line_break_holder] --> </tr><!-- [et_pb_line_break_holder] --> <tr><!-- [et_pb_line_break_holder] --> <td><input type="checkbox" value="1" name="V_A5_IWou4" /> Unfair</td><!-- [et_pb_line_break_holder] --> </tr><!-- [et_pb_line_break_holder] --> <tr><!-- [et_pb_line_break_holder] --> <td><input type="checkbox" value="1" name="V_A5_IWou5" /> Approachable</td><!-- [et_pb_line_break_holder] --> </tr><!-- [et_pb_line_break_holder] --> <tr><!-- [et_pb_line_break_holder] --> <td><input type="checkbox" value="1" name="V_A5_IWou6" /> Unapproachable</td><!-- [et_pb_line_break_holder] --> </tr><!-- [et_pb_line_break_holder] --> <tr><!-- [et_pb_line_break_holder] --> <td><input type="checkbox" value="1" name="V_A5_IWou7" /> Caring</td><!-- [et_pb_line_break_holder] --> </tr><!-- [et_pb_line_break_holder] --> <tr><!-- [et_pb_line_break_holder] --> <td><input type="checkbox" value="1" name="V_A5_IWou8" /> Uncaring</td><!-- [et_pb_line_break_holder] --> </tr><!-- [et_pb_line_break_holder] --> <tr><!-- [et_pb_line_break_holder] --> <td><input type="checkbox" value="1" name="V_A5_IWou9" /> Democratic</td><!-- [et_pb_line_break_holder] --> </tr><!-- [et_pb_line_break_holder] --> <tr><!-- [et_pb_line_break_holder] --> <td><input type="checkbox" value="1" name="V_A5_IWo10" /> Unreliable</td><!-- [et_pb_line_break_holder] --> </tr><!-- [et_pb_line_break_holder] --> </table><!-- [et_pb_line_break_holder] --> <p> </p><!-- [et_pb_line_break_holder] --> <table class="sample sample-formats"><!-- [et_pb_line_break_holder] --> <tr><!-- [et_pb_line_break_holder] --> <td class="survey_number">3.</td><!-- [et_pb_line_break_holder] --> <td colspan="3" class="survey_question"><a name="B7"></a>Performance Standards for each employee are:</td><!-- [et_pb_line_break_holder] --> </tr><!-- [et_pb_line_break_holder] --> <tr><!-- [et_pb_line_break_holder] --> <td rowspan="5"></td><!-- [et_pb_line_break_holder] --> <td></td><!-- [et_pb_line_break_holder] --> <td class="bordered">Yes</td><!-- [et_pb_line_break_holder] --> <td class="bordered">No</td><!-- [et_pb_line_break_holder] --> </tr><!-- [et_pb_line_break_holder] --> <tr><!-- [et_pb_line_break_holder] --> <td class="bordered">Focused on how the job should be performed</td><!-- [et_pb_line_break_holder] --> <td class="bordered"><input type="radio" value="1" name="V_A10_Perf" /></td><!-- [et_pb_line_break_holder] --> <td class="bordered"><input type="radio" value="2" name="V_A10_Perf" /></td><!-- [et_pb_line_break_holder] --> </tr><!-- [et_pb_line_break_holder] --> <tr><!-- [et_pb_line_break_holder] --> <td class="bordered">Focused on a set of mutually agreed to objectives</td><!-- [et_pb_line_break_holder] --> <td class="bordered"><input type="radio" value="1" name="V_A10_Per2" /></td><!-- [et_pb_line_break_holder] --> <td class="bordered"><input type="radio" value="2" name="V_A10_Per2" /></td><!-- [et_pb_line_break_holder] --> </tr><!-- [et_pb_line_break_holder] --> <tr><!-- [et_pb_line_break_holder] --> <td class="bordered">Based on the competencies needed for the position</td><!-- [et_pb_line_break_holder] --> <td class="bordered"><input type="radio" value="1" name="V_A10_Per3" /></td><!-- [et_pb_line_break_holder] --> <td class="bordered"><input type="radio" value="2" name="V_A10_Per3" /></td><!-- [et_pb_line_break_holder] --> </tr><!-- [et_pb_line_break_holder] --> <tr><!-- [et_pb_line_break_holder] --> <td class="bordered">Focused on outcomes, allowing each person to find his or her route</td><!-- [et_pb_line_break_holder] --> <td class="bordered"><input type="radio" value="1" name="V_A10_Per4" /></td><!-- [et_pb_line_break_holder] --> <td class="bordered"><input type="radio" value="2" name="V_A10_Per4" /></td><!-- [et_pb_line_break_holder] --> </tr><!-- [et_pb_line_break_holder] --> </table><!-- [et_pb_line_break_holder] --> <p> </p><!-- [et_pb_line_break_holder] --> <table class="sample sample-formats"><!-- [et_pb_line_break_holder] --> <tr><!-- [et_pb_line_break_holder] --> <td class="survey_number">4.</td><!-- [et_pb_line_break_holder] --> <td class="survey_question"><a name="B8"></a>What do you need most from ABC Company's management team?</td><!-- [et_pb_line_break_holder] --> </tr><!-- [et_pb_line_break_holder] --> <tr><!-- [et_pb_line_break_holder] --> <td rowspan="7"></td><!-- [et_pb_line_break_holder] --> <td><input type="radio" value="1" name="V_A7_WhatD" /> Communication</td><!-- [et_pb_line_break_holder] --> </tr><!-- [et_pb_line_break_holder] --> <tr><!-- [et_pb_line_break_holder] --> <td><input type="radio" value="2" name="V_A7_WhatD" /> Coaching</td><!-- [et_pb_line_break_holder] --> </tr><!-- [et_pb_line_break_holder] --> <tr><!-- [et_pb_line_break_holder] --> <td><input type="radio" value="3" name="V_A7_WhatD" /> Teamwork</td><!-- [et_pb_line_break_holder] --> </tr><!-- [et_pb_line_break_holder] --> <tr><!-- [et_pb_line_break_holder] --> <td><input type="radio" value="4" name="V_A7_WhatD" /> Training</td><!-- [et_pb_line_break_holder] --> </tr><!-- [et_pb_line_break_holder] --> <tr><!-- [et_pb_line_break_holder] --> <td><input type="radio" value="5" name="V_A7_WhatD" /> On-Site Support</td><!-- [et_pb_line_break_holder] --> </tr><!-- [et_pb_line_break_holder] --> <tr><!-- [et_pb_line_break_holder] --> <td><input type="radio" value="6" name="V_A7_WhatD" /> Inter-Departmental Communication</td><!-- [et_pb_line_break_holder] --> </tr><!-- [et_pb_line_break_holder] --> <tr><!-- [et_pb_line_break_holder] --> <td><input type="radio" value="7" name="V_A7_WhatD" /> Other <input maxlength="30" name="V_A7_What2" /> <span class="survey_type">(Question Type: Fill-In-The-Blank)</span></td><!-- [et_pb_line_break_holder] --> </tr><!-- [et_pb_line_break_holder] --> </table><!-- [et_pb_line_break_holder] --> <p> </p><!-- [et_pb_line_break_holder] --> <table class="sample sample-formats"><!-- [et_pb_line_break_holder] --> <tr><!-- [et_pb_line_break_holder] --> <td class="survey_number">5.</td><!-- [et_pb_line_break_holder] --> <td colspan="6" class="survey_question"><a name="B9"></a>Rank these items in order of importance to you. (Use #1 as most important)<br /><span class="survey_type">(Question Type: Rank-Order or Rating)</span></td><!-- [et_pb_line_break_holder] --> </tr><!-- [et_pb_line_break_holder] --> <tr><!-- [et_pb_line_break_holder] --> <td rowspan="8"></td><!-- [et_pb_line_break_holder] --> <td></td><!-- [et_pb_line_break_holder] --> <td class="bordered">1</td><!-- [et_pb_line_break_holder] --> <td class="bordered">2</td><!-- [et_pb_line_break_holder] --> <td class="bordered">3</td><!-- [et_pb_line_break_holder] --> <td class="bordered">4</td><!-- [et_pb_line_break_holder] --> <td class="bordered">5</td><!-- [et_pb_line_break_holder] --> </tr><!-- [et_pb_line_break_holder] --> <tr><!-- [et_pb_line_break_holder] --> <td class="bordered">Benefits</td><!-- [et_pb_line_break_holder] --> <td class="bordered"><input type="radio" value="1" name="V_A8_RankT" /></td><!-- [et_pb_line_break_holder] --> <td class="bordered"><input type="radio" value="2" name="V_A8_RankT" /></td><!-- [et_pb_line_break_holder] --> <td class="bordered"><input type="radio" value="3" name="V_A8_RankT" /></td><!-- [et_pb_line_break_holder] --> <td class="bordered"><input type="radio" value="4" name="V_A8_RankT" /></td><!-- [et_pb_line_break_holder] --> <td class="bordered"><input type="radio" value="5" name="V_A8_RankT" /></td><!-- [et_pb_line_break_holder] --> </tr><!-- [et_pb_line_break_holder] --> <tr><!-- [et_pb_line_break_holder] --> <td class="bordered">Salary</td><!-- [et_pb_line_break_holder] --> <td class="bordered"><input type="radio" value="1" name="V_A8_Rank2" /></td><!-- [et_pb_line_break_holder] --> <td class="bordered"><input type="radio" value="2" name="V_A8_Rank2" /></td><!-- [et_pb_line_break_holder] --> <td class="bordered"><input type="radio" value="3" name="V_A8_Rank2" /></td><!-- [et_pb_line_break_holder] --> <td class="bordered"><input type="radio" value="4" name="V_A8_Rank2" /></td><!-- [et_pb_line_break_holder] --> <td class="bordered"><input type="radio" value="5" name="V_A8_Rank2" /></td><!-- [et_pb_line_break_holder] --> </tr><!-- [et_pb_line_break_holder] --> <tr><!-- [et_pb_line_break_holder] --> <td class="bordered">Job Satisfaction</td><!-- [et_pb_line_break_holder] --> <td class="bordered"><input type="radio" value="1" name="V_A8_Rank3" /></td><!-- [et_pb_line_break_holder] --> <td class="bordered"><input type="radio" value="2" name="V_A8_Rank3" /></td><!-- [et_pb_line_break_holder] --> <td class="bordered"><input type="radio" value="3" name="V_A8_Rank3" /></td><!-- [et_pb_line_break_holder] --> <td class="bordered"><input type="radio" value="4" name="V_A8_Rank3" /></td><!-- [et_pb_line_break_holder] --> <td class="bordered"><input type="radio" value="5" name="V_A8_Rank3" /></td><!-- [et_pb_line_break_holder] --> </tr><!-- [et_pb_line_break_holder] --> <tr><!-- [et_pb_line_break_holder] --> <td class="bordered">Job Security</td><!-- [et_pb_line_break_holder] --> <td class="bordered"><input type="radio" value="1" name="V_A8_Rank4" /></td><!-- [et_pb_line_break_holder] --> <td class="bordered"><input type="radio" value="2" name="V_A8_Rank4" /></td><!-- [et_pb_line_break_holder] --> <td class="bordered"><input type="radio" value="3" name="V_A8_Rank4" /></td><!-- [et_pb_line_break_holder] --> <td class="bordered"><input type="radio" value="4" name="V_A8_Rank4" /></td><!-- [et_pb_line_break_holder] --> <td class="bordered"><input type="radio" value="5" name="V_A8_Rank4" /></td><!-- [et_pb_line_break_holder] --> </tr><!-- [et_pb_line_break_holder] --> <tr><!-- [et_pb_line_break_holder] --> <td class="bordered">Career Opportunities</td><!-- [et_pb_line_break_holder] --> <td class="bordered"><input type="radio" value="1" name="V_A8_Rank5" /></td><!-- [et_pb_line_break_holder] --> <td class="bordered"><input type="radio" value="2" name="V_A8_Rank5" /></td><!-- [et_pb_line_break_holder] --> <td class="bordered"><input type="radio" value="3" name="V_A8_Rank5" /></td><!-- [et_pb_line_break_holder] --> <td class="bordered"><input type="radio" value="4" name="V_A8_Rank5" /></td><!-- [et_pb_line_break_holder] --> <td class="bordered"><input type="radio" value="5" name="V_A8_Rank5" /></td><!-- [et_pb_line_break_holder] --> </tr><!-- [et_pb_line_break_holder] --> <tr><!-- [et_pb_line_break_holder] --> <td class="bordered">Training</td><!-- [et_pb_line_break_holder] --> <td class="bordered"><input type="radio" value="1" name="V_A8_Rank6" /></td><!-- [et_pb_line_break_holder] --> <td class="bordered"><input type="radio" value="2" name="V_A8_Rank6" /></td><!-- [et_pb_line_break_holder] --> <td class="bordered"><input type="radio" value="3" name="V_A8_Rank6" /></td><!-- [et_pb_line_break_holder] --> <td class="bordered"><input type="radio" value="4" name="V_A8_Rank6" /></td><!-- [et_pb_line_break_holder] --> <td class="bordered"><input type="radio" value="5" name="V_A8_Rank6" /></td><!-- [et_pb_line_break_holder] --> </tr><!-- [et_pb_line_break_holder] --> <tr><!-- [et_pb_line_break_holder] --> <td class="bordered">Work-Life Balance</td><!-- [et_pb_line_break_holder] --> <td class="bordered"><input type="radio" value="1" name="V_A8_Rank7" /></td><!-- [et_pb_line_break_holder] --> <td class="bordered"><input type="radio" value="2" name="V_A8_Rank7" /></td><!-- [et_pb_line_break_holder] --> <td class="bordered"><input type="radio" value="3" name="V_A8_Rank7" /></td><!-- [et_pb_line_break_holder] --> <td class="bordered"><input type="radio" value="4" name="V_A8_Rank7" /></td><!-- [et_pb_line_break_holder] --> <td class="bordered"><input type="radio" value="5" name="V_A8_Rank7" /></td><!-- [et_pb_line_break_holder] --> </tr><!-- [et_pb_line_break_holder] --> </table><!-- [et_pb_line_break_holder] --> <p> </p><!-- [et_pb_line_break_holder] --> <table class="sample sample-formats"><!-- [et_pb_line_break_holder] --> <tr><!-- [et_pb_line_break_holder] --> <td class="survey_number">6.</td><!-- [et_pb_line_break_holder] --> <td class="survey_question"><a name="B10"></a>My greatest concern as an employee is...<br /><span class="survey_type">(Question Type: Verbatim or Write-In Response)</span></td><!-- [et_pb_line_break_holder] --> </tr><!-- [et_pb_line_break_holder] --> <tr><!-- [et_pb_line_break_holder] --> <td class="survey_number"></td><!-- [et_pb_line_break_holder] --> <td colspan="2"><textarea name="V_A9_MyGre" rows="3" cols="50"></textarea></td><!-- [et_pb_line_break_holder] --> </tr><!-- [et_pb_line_break_holder] --> </table><!-- [et_pb_line_break_holder] --> <p> </p><!-- [et_pb_line_break_holder] --> <p>Thank you for your participation.  Your responses are important to us. Once we have received all responses, we will inform you of the results.</p><!-- [et_pb_line_break_holder] --> <!-- Submit and Reset buttons --><!-- [et_pb_line_break_holder] --> <p><input class="btn" id="submit" type="submit" value="Submit" name="Submit" /> <input class="btn" type="reset" value="Reset" id="reset" name="reset" /></p><!-- [et_pb_line_break_holder] --> <!-- [et_pb_line_break_holder] --> <!-- SAMPLE SURVEY end -->