Sample job analysis questionnaire (open-ended)

NAME:

TITLE:

OFFICE OR BRANCH LOCATION (Address & City)

INSTRUCTIONS FOR COMPLETING THIS QUESTIONNAIRE

1.

Answer each question as completely and accurately as possible. Remember to complete the top of this page.

2.

If additional space is required for any answers, please use additional paper and number each answer accordingly. Place these additional pieces of paper in the Questionnaire and staple securely.

3.

Review the Questionnaire and your answers with your immediate supervisor. This is to ensure you are both in agreement as the responsibilities and duties of your job.

4.

Make sure both you and your supervisor sign and date the Questionnaire where indicated.

5.

Place the completed Questionnaire in the enclosed envelope and return it to:

6.

If you or your supervisor have any questions, please call the project office in

7.

PLEASE RETURN THE ENCLOSED QUESTIONNAIRE NO LATER THAN MAY

JOB RESPONSIBILITY QUESTIONNAIRE

(Please Type or Print)

Name:  

Office or Branch Location:  

Your Position Title:  

Department:  

Division:  

Name of Immediate Supervisor:  

Your Supervisor's Title:  

1.

Basic Function - Please state in three or four lines the major reason for your job.

2.

Primary Duties and Activities - Please list and describe all activities and duties which occupy a major part of your time on the job. Be as specific as possible, and list the most important first. Please show the approximate percent of time spent in each activity during a representative month. The total percentage of time should add up to 100%. If you have a current, accurate Job Description, please attach to this questionnaire.

Duty/Activity

% of Time

3.

Supervision - Please explain to what extent your job involves Supervisory responsibility for others. List the Titles of persons reporting directly to you, if any, showing the number of persons in each job.

Titles

Number of Persons

Total number of individuals you supervise.

To what degree are you expected to instruct or train others?

4.

(a)

Skills Required - Please comment on each of the following areas as applicable to your job.

What machines, equipment or tools are used on your job?

(b)

Please list any licenses, certificates, or other formal qualifications required for your job.

(c)

What manual skills are required on your job?

(i)

What part of your job requires precision or dexterity on a regular basis?

(ii)

Describe the speed and accuracy required, along with the frequency of such movements.

(d)

What reports, procedures, or illustrations do you write or prepare? Include completion of those forms that are a major part of your job.

5.

(a)

Background Required - Please describe the minimum education, training, and experience background you believe is needed for your job. For example, "high school education plus three months as a mail clerk plus three months as a file clerk."

(b)

Do you require any special courses or training to perform your job (May be taken as Bank sponsored or conducted courses) if so, please list and explain.

6.

Working Conditions - Please comment on the following as they relate to your job.

(a)

(i)

Describe any heavy lifting, or other exertion required in your job (indicate frequency).

(ii)

Describe the amount of heavy or constant visual attention or strain that is required when performing your job.

(b)

(i)

Does your job often require you to work outside?

Yes

No

If so, how often?

(ii)

Do you work in disagreeable or uncomfortable physical surroundings?

Yes  

No  

If yes, please explain and indicate frequency of occurrence. (Consider such things as noise, dust, fumes, heat, cold, etc.)

(c)

Do you work with or around dangerous equipment or devices that could injure you or others in your area?

Yes

No

If yes, please explain.

(d)

Does your job require you to work nights, or weekends or non-regular hours?

Yes  

No  

If yes, please explain.

(e)

Are you required to travel on business? Yes  No  

If yes, please explain.

(f)

Would you consider your work location and conditions to be typical of:

Standard Branch  Standard Office  Other  If other, please describe:

7.

Contacts - Who do you communicate with on a regular basis in order to do your job?

(a)

Within the Branch, Department, other Departments, other Branches, etc.:

(b)

Outside the Bank (with customers, clients, suppliers, the general public or other organizations):

8.

Safeguarding Responsibility - Please describe any responsibility your job carries for safeguarding:

(a)

Confidential information (customer data, payroll data or personnel data, etc).

(b)

Bank or Customer funds or property (cash receipts, securities, equipment)

(c)

If you have responsibility for safeguarding negotiable securities or cash:

(i)

What is the location of these securities and/or cash?  

(ii)

What is the average value and nature of the securities and/or cash?

(iii)

For what periods of time and how often do you have safeguarding responsibilities for securities and/or cash?  

(d)

Are you directly or indirectly responsible for the physical safety of:

other employees;  customers;  general public  . If so, please explain.

9.

(a)

To what extent are your duties standardized and routine?  

(b)

Describe the difficult or complex elements of your job. Please give examples.

(c)

In what areas must you plan and use your initiative?  

(d)

What decision can you make without reference to your supervisor?

(e)

Under what circumstances, or for what type of decisions are you required to consult your supervisor or manager?  

(f)

What is the nature of work instructions given to you and how are they communicated?

10.

(a)

Explain the nature of any major working relationships that you are expected to initiate or maintain with other areas of the Bank. These might include, for example:  

(b)

Please describe any aspects of your job which requires you to provide functional guidance or advice to others in these areas.

11.

General Comments - Please add any other comments about the nature of your job, the difficulties involved, or any other items which you think would help provide a better understanding of your job.

Please review the questionnaire to make sure you have not overlooked any important items.

Have your supervisor review the questionnaire with you and sign it to indicate concurrence and approval.

Thank you for your cooperation.

Signature of Employee Completing Questionnaire

Date

Signature of Supervisor

Date

Hansen