Employer Evaluation by Worker
Your Name
Your answer
Employer/Business Name
Your answer
Your Recruitment Agent's Name
Personal Interaction
Please rate the following:
Very bad problem
Problem when sharing accomodations
Sometimes a problem
Not a problem
Not applicable
Employer's smoking habit
Employer's drinking habit
Employer's use of foul language
Employer's personal hygiene
Very poor
Poor
Fair/Average
Good
Excellent
Your working relationship with your employer
Employer's ability to communicate
Employer's ability to give instructions
Employer's ability to plan and organize work
Employer's ability to interact with others
Employer's fairness
Employer's kindness
Employer's work ethic
Employer's ability to handle stress
Very dishonest
Not sure
Mostly honest
Honest
Always honest
Employer's level of honesty
No patience at all
Not very patient
Fair/Average
Mostly patient
Extremely patient
Employers patience to teach you new things
Extremely poor
Poor
Fair/Average
Good
Excellent
Employer's level of patience
Never
Once or twice
Sometimes 
Most of the time
Always
Do you feel that you were treated with respect?
Frequently
Sometimes
Now and then
Seldom
Never
Did you or others have to endure verbal abuse?
All of the time
Most of the time
Sometimes
Rarely
Never
Was your employer a bully?
Was your employer racist or discriminatory?
Meals and Accomodations
Not applicable
Never
Sometimes
Every meal
More than enough
Were you provided with meals?
Not applicable
Bad
Fair/Average
Good
Excellent
If you were provided with meals, please rate the average meal quality.
Not Applicable
None
1 meal per day
2 meals per day
3 meals per day
How many meals on average did you receive per day?
Not applicable
Bad facilities
Fair facilities
Good facilities
Excellent facilities
Did you have facilities to prepare meals?
Extremely poor
Poor
Fair/Average
Very nice
Excellent place to live
Please rate your living accommodations.
Not applicable
Never
Seldom
Enough
Every time I needed to
Were you provided with the opportunity to buy groceries?
Pay/Hours
Did not know we would be
No, not a cent
Still waiting to receive it
Only the first 50%
The full amount
Were you reimbursed for your plane ticket?
Less than 40 hrs per week
40-60 hrs per week
60-80 hrs per week
80-100 hrs per week
100+ hrs per week
On average, how may hours did you work per week?
Lots more than expected
Lots less than expected
As much as expected
Worked enough hours
Perfect number of hours
How do you feel about the numbers of hours you worked?
Never
Often late paying
Generally on time
Always on time
Excellent pay (bonus)
Were you paid on time/when you expected?
Not at all
Seems less than I expected
Most of the time
Always paid correctly
Was paid more than was agreed
Did you receive the correct pay for the hours you worked?
Never discussed
Was promised but never materialized
Given a bonus but less than promised
I did receive a bonus
Received an excellent bonus
Were you ever offered an incentive bonus?
Return
Never
Only if things change
Maybe
I am planning to do so
Definitely 
Would you like to return to your current employer?
Not at all
Not sure
Seems like it
Yes
I feel like family
Do you feel that the employer cares about you as a person?
Are there any other comments you would like to make concerning this specific employer?
Your answer
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