Leadership Development GROUND BREAKER Program Survey

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* 7. What range is your current pay rate in?

$11-$20 per hour

$21-$30 per hour

$31-$40 per hour

Over $41 per hour

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* 8. About how long have you been in your current position?

Years

Months

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* 9. What position are you interested in?

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* 10. What is your phone number?

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* 11. What is your e-mail address?

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* 12. What was the nature of your responsibilities in your previous roles?

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* 13. Have you held any leadership positions outside of your work life? If yes, please explain.

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* 14. Do you speak any other languages other than English?

Yes

If yes, which languages do you speak?

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* 15. Do you have a valid Driver's License?

Yes

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* 16. Would you be willing to relocate to another city? (With compensation to convey reasonable relocation costs?) Rate your enthusiasm for relocation.

Yes, Sign me up! Can't wait to move.

Very likely. It would depend on location, pay and opportunity.

Not at this time but maybe in the future.

No, never! I don't ever want to leave my awesome city!

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* 17. What is the farthest that you would consider moving away? (With compensation to cover relocation costs?

10 miles or less

50 to 100 miles

500 to 1000 miles

I'm willing to go wherever this adventure takes me!

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* 18. Tell us about your computer skills. Select below the programs you have used.

Microsoft Outlook

Microsoft Word

Microsoft Excel

Microsoft Power Point

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* 19. Rate your proficiency with the following computer programs.

	Never Used	Novice	Somewhat Proficient	Proficient	Extremely Proficient
Microsoft Outlook	Microsoft Outlook Never Used	Microsoft Outlook Novice	Microsoft Outlook Somewhat Proficient	Microsoft Outlook Proficient	Microsoft Outlook Extremely Proficient
Microsoft Word	Microsoft Word Never Used	Microsoft Word Novice	Microsoft Word Somewhat Proficient	Microsoft Word Proficient	Microsoft Word Extremely Proficient
Microsoft Excel	Microsoft Excel Never Used	Microsoft Excel Novice	Microsoft Excel Somewhat Proficient	Microsoft Excel Proficient	Microsoft Excel Extremely Proficient
PowerPoint	PowerPoint Never Used	PowerPoint Novice	PowerPoint Somewhat Proficient	PowerPoint Proficient	PowerPoint Extremely Proficient

Please be specific and describe how you have used these programs.

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* 1. Today's Date

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* 2. What is your first name?

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* 3. What is your last name?

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* 4. What account are you currently working at?

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* 5. What city do you currently work in?

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* 6. What is your current position?

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* 7. What range is your current pay rate in?

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* 8. About how long have you been in your current position?

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* 9. What position are you interested in?

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* 10. What is your phone number?

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* 11. What is your e-mail address?

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* 12. What was the nature of your responsibilities in your previous roles?

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* 13. Have you held any leadership positions outside of your work life? If yes, please explain.

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* 14. Do you speak any other languages other than English?

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* 15. Do you have a valid Driver's License?

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* 16. Would you be willing to relocate to another city? (With compensation to convey reasonable relocation costs?) Rate your enthusiasm for relocation.

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* 17. What is the farthest that you would consider moving away? (With compensation to cover relocation costs?

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* 18. Tell us about your computer skills. Select below the programs you have used.

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* 19. Rate your proficiency with the following computer programs.

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* 20. Tell us about a "Bad Boss" you have had before. What did you not like about them?

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* 21. What are some characteristics that you believe a leader at Block by Block should possess?

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* 22. How do you motivate others? Give specifics about how you would lead a team of Ambassadors. Don't just say "leading by example".

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* 23. But, since you're thinking about it...give us an example of when you have lead by example.

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* 24. Tell us about a time that you didn't know how to accomplish something but you figured it out.

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* 25. Why do think you would make a good part of the Block by Block Leadership Team?