Employee Recognition Questionnaire - Human Resources
Employee Recognition Questionnaire
INSTRUCTIONS Modify this form as needed. This optional form is used to assist supervisors and managers with their employee recognition efforts and does not imply that recognition must be given or received. Please complete and return the form to your supervisor or manager.
Employee Name
Title
Work Anniversary Date
Birthday (month/date)
1. What are some work accomplishments and/or contributions you would appreciate being recognized for by your
manager or supervisor?
Customer service
Consistent job performance
Innovative ideas or processes
Collaboration or support of a team effort
Taking on extra responsibilities or special projects
Other, please describe:
2. What would you find meaningful in being recognized for the work accomplishments and/or contributions listed above? Verbal acknowledgement ________________________ Personal note or card Lunch with supervisor ___________________________ Administrative leave with pay Other, please describe:
3. In what type of setting are you most comfortable with in receiving recognition? Private ______________________________________ Public Unit/small group _______________________________ No preference Other, please describe:
4. Please list some of your favorite things so that your manager or supervisor may get to know you better. (Please fill in the blanks, if applicable.)
a) Favorite drink
f) Favorite retail store
b) Favorite snack
g) Favorite flower
c) Favorite dessert
h) Favorite sports team
d) Favorite food
i) Other
e) Favorite restaurant
5. Please provide any additional information you would like us to know.
For Supervisor Use Only - Keeping Track of Employee Recognition
Date Employee Received Recognition
Why Employee Received Recognition
Type of Reward or Recognition Received
Employee Recognition Questionnaire #615
05/20/13 Page 1 of 1
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