Section 1 -- Biographical Information

DOE-HDBK-1078-94

ATTACHMENT 4

SAMPLE SURVEY QUESTIONNAIRE

(Continued)

SECTION I--BIOGRAPHICAL INFORMATION

Name:

Date:

What is your present job level? (Mark one)

Supervisor

Operator

Operator Trainee

How long have you worked in your present job title?

Year(s)

Month(s)

What is the highest level of education you have received?

Grade school

Attended high school, but did not graduate

Graduated from high school or equivalent

Attended trade/vocational school, but did not graduate

Graduated from trade/vocational school

Attended college, but did not graduate

Graduated from college.

How many years of formal vocational/technical education have you had beyond high school?

a. Military schools

years

months

b. Nonmilitary schools

years

months.

Please place a check mark beside each of the areas below in which you have had at least six (6)

months experience:

Area I:

C-331

Area III:

C-360

C-315

C-350

C-310

C-340

C-310A

Area II:

C-333

Area IV:

C-337

C-333A

C-337

RCW

C-300

Building: