(You may want some sort of endorsement from a CEO or manager to increase confidence that this issue matters.)
We are keen to explore whether there are any particular issues for men with fathering responsibilities within this organisation. We want to find out what we are doing well to assist fathers balance their work and family life, and how we could improve. Your answers are confidential. Please return this questionnaire to:………………………………..by …………………
Thank you for your help.
Section 1: Demographic information
1. How old are you?
(Under 30 years
(Over 40 years
2. How many children do you have?
( 1( 2( 3( 4 ( 5( more than 5
3. How old are your children?
( Under 2 years
( 2-5 years
( 6-10 years
( over 18 years
4. Do any of your children have a disability or special needs?
( Yes( No
Having a balance
5. Do you generally feel you are able to balance your work and family life?
( Yes( No
6. Do you currently use any of the work-life policies or programmes provided by the organisation?
( Yes( No
7. Do any of the following help you balance your work and family commitments?
| |Yes |No |Not available to me |Not applicable to me | |Flexible starting times | | | | | |Flexible finish times | | | | | |Flexible hours generally | | | | | |Time off for family emergencies &| | | | | |events | | | | | |Part-time or reduced work hours | | | | | |Time off in school holidays | | | | | |Compressed working week/fortnight| | | | |
8. Do any of the following hinder you in balancing your work and family commitments?
| |Yes |No |Not applicable to me | |Long work hours | | | | |Compulsory over time | | | | |Weekend work | | | | |Shift work | | | | |Timing of work meetings/training | | | |
Support from others
9. Do any of the following help you balance your work and family commitments?
| |Yes |No |Not available to me |Not applicable to me | |Support from manager/supervisor | | | | | |Support from colleagues | | | | | |Support from team members | | | | | |Encouragement to use paid and unpaid | | | | |...