Strongly disagree Strongly agree or

or very dissatisfied very satisfied

Please put an 'x' in the range 1 to 7 to indicate your level of (dis)agreement with each statement

1 I experience joy in my work              

2 I believe others experience joy as a result of              

my work

3 My work does not give meaning to my life              

4 My spirit is energised by my work              

5 I feel part of a community in my immediate              

workplace (department, unit, etc.)

6 I am not able to use my gifts and talents at              

my work

7 The work I do is connected to what I think is              

important in life

8 I look forward to coming to work most days              

9 I see a connection between my work and the              

larger social good of my community

10 My supervisor encourages my personal

growth              

11 I have had numerous experiences in my job              

which have resulted in personal growth

12 I understand what gives my work personal              

meaning

13 I feel responsible for my own growth              

14 I feel personally responsible for my behaviour              

15 When I have fears, I am encouraged to              

discuss them

16 When I have a concern, I (re)present it to the              

appropriate person

17 At work, we work together to resolve conflict              

in a positive way

18 I am evaluated fairly here              

19 I am encouraged to take risks at work              

20 I am valued at work for who I am              

21 I feel hopeful about life              

22 My spiritual values influence the choices I              

make

23 I consider myself a spiritual person              

24 There is no room for spirituality in the              

workplace

25 Prayer is an important part of my life              

26 I care about the spiritual health of my co-              

workers

27 Spiritual values are not considered important              

in my workplace

28 I am not aware of what is truly meaningful to              

me

29 Meditation is an important part of my life              

30 Personal reflection is an important part of my              

life

31 Who I am as a human being is not valued in              

the workplace

32 The organisation I work for cares about              

whether my spirit is energised by my work

33 I feel positive about the values of this              

organisation

34 This organisation is concerned about the poor              

in our community

35 This organisation cares about all its              

employees

36 This organisation has a conscience              

37 I feel connected with this organisation’s goals              

38 This organisation is concerned about the              

health of those who work here

Personal details : amend the example information to suit your circumstances

Age
Sex (m/f)
Single, married, partner, separated, divorced
Nationality
Ethnic origin?
Religion:        
Faith attending:
with strong focus on place of worship  
or carried into workplace  
 
Faith not attending:
owing to arrested spiritual development  

or moved spiritual development elsewhere

 

Without named faith  

Highest qualification
Organisation type or company
Do you report to anyone?  
Do people report to you?  
Job position e.g. Teacher, Professor

Years at this employer

Years in this position
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