Template for gathering demographic information. Instructions for the respondent are in italics.
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What is your full name?

Write your first name and surname in the spaces below.
First name
Surname
Write your age in years in the space below.
What is your gender?

Please tick the relevant box.
Male
Female
In which department do you work?
Edit the question to list the departments within your company. This question can also be altered or copied to ask about divisions, branches and sections.

Please tick the relevant box.
Department 1
Department 2
Department 3
Department 4
Department 5
Where is your office located?
Edit the question to list the locations of the branches of your company.

Please tick the relevant box.
Location 1
Location 2
Location 3
Location 4
Location 5
What is your job title?
Write your job title in the space below.
What is your supervisor's job title?
Write your supervisor's job title in the space below.
How long have you been with the organisation?
Write your answer to the nearest year in the space below. If you've been with the organisation for less than a year, please write the number of months as a decimal fraction of a year - for example, if you've been with the organisation 6 months, then write 0.5 years.
How long have you been in your current position in the organisation?
Write your answer to the nearest year in the space below. If you've been in your current position for less than a year, please write the number of months as a decimal fraction of a year - for example, if you've been with the organisation for 6 months, then write 0.5 years.
How many people do you supervise on a day-to-day basis?
Write your answer in the space below.
Do you work part-time or full-time for the organisation?
Please tick the relevant box.
Part-time
Full-time
How much experience have you had in your current area of work?
Write your answer to the nearest year in the space below. If either of the values is less than a year, please write the number of months as a decimal fraction of a year - for example, if you've had 6 months experience in your current area of work, please write 0.5 years.
At this organisation
At previous organisations
What is your highest level of education?
Please tick the relevant box.
GCSE/O Levels
A levels
Diploma
Bachelor's degree
Master's degree
Doctor's degree
Other
How many years of formal schooling have you had?
(Please include primary, secondary and tertiary education.)
Please note that the following three questions cover sensitive issues. Consider whether you really need the questions. If you do, then place them last in the demographic section, and state exactly what the purpose of asking the questions is, and who will have access to the information. You may also want to state that answering the questions is optional.
What is your ethnic identity?
Write your ethnic identity in the space below.
What is your religion?
Write your religion in the space below. If you have no religion, please write None.
This question is phrased in terms of salary. It may be more appropriate to ask about annual income. Salary information is also likely to be available from the personnel files.
What is your approximate salary?


This survey was created byKeyPoint