SAMPLE

COMPRESSED WORK WEEK (CWW) SURVEY

(Name of organization) is considering implementing a compressed workweek program with some or all employees. Currently employees work a variety of schedules, primarily five days per week and eight hours per day. If implemented, the new schedule will be based on supervisor approval and consist of four 10-hour days each week or eight 9-hour & one 8-hour days every two weeks (employees would still be expected to work 40 hours per week). Participation in the CWW program will strictly voluntary – please return this survey to ______no later than ______.

This questionnaire is designed to get our employees' input, perceptions and attitudes on this new work option prior to implementation. Please keep in mind that a program of this type will be implemented solely at the discretion of management and not necessarily based on majority rule.

Name______

Department ______

Phone or extension ______

1. Have you worked a compressed schedule previously?  Yes  No

1a) If yes, please specify  4/10s9/80s3/36sother

2. Please describe your current schedule.

Start times:

Sunday / Monday / Tuesday / Wednesday / Thursday / Friday /

Saturday

am
pm / am
pm / am
pm / am
pm / am
pm / am
pm / am
pm

Stop times:

Sunday / Monday / Tuesday / Wednesday / Thursday / Friday /

Saturday

am
pm / am
pm / am
pm / am
pm / am
pm / am
pm / am
pm

2a) Are you currently satisfied with this schedule?  Yes  No

3. Do you anticipate any difficulty in adjusting to a compressed work schedule?

Yes No

3a) If yes, why? (Please check all that apply.)

FatiguePersonal schedule (i.e. child care, school, etc)

Current job dutiesConflict with current commute arrangements

3b) Do you think these issues can be resolved? Yes No

3c) If no (or if yes to 3b) what schedule would you most prefer to work?

(Rate all -- 3 = most interested, 2 = somewhat interested, 1 = not at all interested)

4/10s 9/80s 3/36sother ______

4.How comfortable do you think you would be if asked to change your existing schedule?

Very comfortableComfortable

Not comfortableI would seek other employment

4a)If you answered very comfortable or comfortable, what advantages do you expect? (Check all that apply.)

More customer contactLess stressGreater productivity

Better work qualityMore free timeLess commuting

More job satisfaction Reduced absenteeism Reduced cost

Other ______

5. Additional comments:

______

______

______

______