JOB ANALYSIS QUESTIONNAIRE
Position Status:
Full-time.
Part-time. Please indicate how many hours you are scheduled to work per week. ________
General Instructions:
The job information requested in this questionnaire should be prepared by the employee and, upon completion,
submitted to his or her supervisor for review. Employees should focus responses on those duties that are
considered to be a normal expectation of their position.
The job purpose is a brief narrative picture of the job that explains why it exists. In one sentence, explain what you do and why the job
must be performed.
Employee Name: ________________________________________________________________________________________
Employee Identification Number: _____________________ Position Code: ______________________________________
Current Job Title: ________________________________________________________________________________________
Job Code: _____________________________________ Department: ___________________________________________
Reports to: __________________________________________________________ Date: __________________________
I
J
OB PURPOSE
Reset Form
Page 2 Rev1 as of 11-Dec-2014
Essential Job Functions describe the major end results for which a job is designed to be answerable or responsible. Essential functions
are accomplishments that must be achieved to call the job complete.
Please list the functions performed by your job, the percent of time spent on each function and prioritize the importance of each
responsibility. Although the following pages allow room for six functions, many jobs will have fewer. The 5-point scale measuring
the importance of each responsibility begins with "essential" and ends with "marginal." Essential functions are those that are
fundamental to the job. They reflect what the job is designed to do/accomplish. Marginal responsibilities are those that are performed
infrequently or those that could be performed by others without altering the underlying reason that the job exists. To help you
determine percentages, think of the entire year as just one day. Of that day, what percent of time do you spend on various duties?
In addition, please circle the function that represents the primary duty of the job. The primary duty may or may not require
the most time, but represents the key reason that the job exists.
EXAMPLE
Percent of time spent on
function:
_25_%
Priority (check one):
x Essential
___ Very important
___ Important
___ Somewhat important
___ Marginal
Function:
Payroll administration for the maintenance department - Collecting payroll information from
department employees on a weekly basis; reviewing the collected information to make sure that it is
complete; forwarding all appropriate documentation (time cards, requests for time off, etc.) to the
business office for processing.
Percent of time spent on
function:
______%
Priority (check one):
___ Essential
___ Very important
___ Important
___ Somewhat important
___ Marginal
Function 1:
I
I
E
SSENTIAL
J
OB FUNCTION
S
Primary
Duty
Page 3 Rev1 as of 11-Dec-2014
Percent of time spent on
function:
______%
Priority (check one):
___ Essential
___ Very important
___ Important
___ Somewhat important
___ Marginal
Function 2:
Percent of time spent on
function:
______%
Priority (check one):
___ Essential
___ Very important
___ Important
___ Somewhat important
___ Marginal
Function 3:
Percent of time spent on
function:
______%
Priority (check one):
___ Essential
___ Very important
___ Important
___ Somewhat important
___ Marginal
Function 4:
Page 4 Rev1 as of 11-Dec-2014
Percent of time spent on
function:
______%
Priority (check one):
___ Essential
___ Very important
___ Important
___ Somewhat important
___ Marginal
Function 5:
Percent of time spent on
function:
______%
Priority (check one):
___ Essential
___ Very important
___ Important
___ Somewhat important
___ Marginal
Function 6:
Page 5 Rev1 as of 11-Dec-2014
Qualification requirements include education, experience, licensing and training required for the job. Do not comment on your own
experience, education or licensing, rather indicate the minimum level required to perform the essential job functions.
What is the typical level of formal education required for your position? Please indicate only one response.
Please specify the field of study or degree related to the level of formal education selected above: _____________________________
What number of years of experience related to the current job do you believe is necessary for an employee entering the position?
Please indicate only one response.
Are there any special certification, licenses and/or accreditation that are required for your position?
No licenses, certification or accreditation required for this position.
Licenses, certification or accreditation required. Please provide detail: ____________________________________
____________________________________________________________________________________________
Does your position require any additional training or specific experience to perform the essential functions? If yes, please
describe.
1 year or less
More than 1 year up to 3 years
More than 10 years
More than 3 years up to 5 years
More than 5 years up to 10 years
III QUALIFICATIONS
Less than hi
h school
Four-year college degree or higher
Hi
g
h school or e
q
uivalent
Two year college or technical degree
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Identify any specific knowledge, skills and/or abilities required to perform the essential functions of this job that have not been
documented already in the JAQ.
Knowledge, Skill or Ability: Please Describe how this knowledge, skill or ability is applied in the job:
Example – Ability to operate office
machines (i.e., photocopier, facsimile
machine, telephone).
Operate photocopier, facsimile and telephone to direct incoming calls and perform
basic secretarial duties for the department.
Example – Budget Management To provide expected services within expenditures and budgetary guidelines. I must
decide to approve or disapprove budgetary exceptions.
Please select the statement that best describes your supervisory responsibility. Supervisory responsibility is defined as duties
associated with personnel actions.
I do not supervise anyone.
I provide guidance and training to others and give input to my supervisor regarding other employees’ performance, but I do
not make hiring and firing recommendations.
I provide guidance and training to others. I do not conduct performance evaluations, but my opinion of other employees’
performance is given particular weight in my supervisor’s hiring, advancement/promotion and firing decisions.
I have primary responsibility for conducting performance evaluations and making recommendations for hiring and firing
employees.
Please indicate the number of individuals you directly supervise: _____
Please indicate the number of individuals who report to a supervisor reporting to you: _____
IV
K
NOWLEDGE
,
S
KILLS & ABILITIES
V REPORTIN
G
RELATIONSHIP
S
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Your Supervisor’s Position Title:_________________________________________________________________________________
Positions that Report Directly to you: Number of Employees in that Position:
Do you manage a department or division?
Yes No
Do you have the authority to hire and fire employees?
Yes No
If you do not have the absolute authority to hire and fire, are your recommendations sought and given serious consideration?
Yes No
Every job requires the employee to solve problems. For example, a job might require the employee to choose one of two ways to
handle a disgruntled customer or allocate a budget. Select the one statement below that best describes the highest level of problems
you solve. Also, select the statement that best describes your authority to solve the problem.
Kinds of problems (check one below): Discretion used for solving problems (check one below):
The problems in my job usually come up again and again.
The problems in my job are somewhat varied, but often
routine.
The problems in my job are varied.
The problems that come to me are usually the ones that
other employees have not been able to handle.
I have to check with my supervisor before I do anything
other than what the established procedure states.
I check with my supervisor if none of the usual alternatives
fit the situation.
I get help from my supervisor or others in handling unusual
problems.
I need to come up with the solution.
V
I
PROBLEM
S
OLVING
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Please list examples of problems that you frequently solve as part of your job. Then tell us the policies, manuals, procedures, rules or
guidelines you use to fix the problem. Is there a manual, policy or procedure that you must follow or must you rely on independent
judgment to solve the problem?
Problems
Policies, Manuals, Procedures, Rules or Independent
Judgment
1.
2.
3.
In order to solve problems, people typically rely on information and facts. How available and usable are the facts and information
necessary to solve the usual problems in your job? Please select the statement that best describes the information you need to rely on
to solve problems.
Specific information is immediately available and usable, such as a manual or established policies and procedures.
Specific information is normally available and in a readily usable form.
General information is normally available. Specific information usually has to be sought elsewhere.
Information may be incomplete or in a form not readily usable. Specific information almost always needs to be sought
elsewhere to fill in gaps.
Information is often vague or misleading. Specific information, if available, almost always needs to be sought elsewhere.
When you make a decision in your job, who does it affect? Complete the following sentence by checking the appropriate box(es).
When I make a decision, it primarily affects:
My work.
The work of others in my work group.
The work of others in my department.
Others in work areas outside my department.
The public.
VII
D
ECISION MAKING
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Please describe decisions that you are responsible for making and that you are held accountable for the result.
1.
2.
3.
Please provide examples of typical errors that could be made in your job. (Please consider these errors when responding to the
following two questions.)
1.
2.
Who would catch the errors and how long it would take to detect? (Please respond in consideration of the errors described in the
question above.)
1.
2.
What is the approximate cost of money, time and/or effort it would take to correct the errors? Please also include the harm or hardship
that the errors may cause other individuals. (Please respond in consideration of the errors described in the question above.)
1.
2.
VII
I
C
ONSEQUENCES OF
E
RROR
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How much on-the-job time is spent in the following PHYSICAL ACTIVITIES? Show the amount of time by checking all
applicable responses below.
Activity
Never
(0%)
Rarely
(up to 15%)
Occasionally
(16% to 40%)
Frequently
(41% to 70%)
Regularly
(over 70%)
Specific Examples
Sitting
Talking
Hearing
Feeling attributes of
objects
Grasping
Pushing
Standing
Walking
Driving
Reaching with hands/arms
Stooping, kneeling,
crouching, crawling
Climbing or balancing
Repetitive wrist, hand
and/or finger movement
Operate mechanical
equipment
Moving up and down from/to
sitting position on the floor
Identify which VISUAL ACTIVITIES are usually required during a typical workday in order to accomplish the essential
functions of this position. Indicate all applicable responses.
Clarity of vision at 20 feet or more.
Clarity of vision at 20 inches or less.
Three-dimensional vision—ability to judge distance and space relationships.
Precise hand-eye coordination.
Ability to identify and distinguish colors.
Describe specific examples of visual activities.
IX
W
ORK
E
NVIRONMENT
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Does this job require exposure to any of the following ENVIRONMENTAL CONDITIONS? Please select the amount of time
spent in each environmental condition and indicate which job duties are affected by the condition(s).
Environmental Condition
Never
(0%)
Rarely
(up to 15%)
Occasionally
(16% to 40%)
Frequently
(41% to 70%)
Regularly
(over 70%)
Specific Examples
Work in confined spaces
Wet, humid conditions (non-
weather)
Varying, inclement outdoor
weather conditions
Vibration
Work in hazardous traffic
conditions
Extreme cold (non-weather)
Extreme heat (non-weather)
Subject to oils (mechanical or
food)
Required to wear a respirator
Fumes or airborne particles
Work near moving
mechanical parts
Work in high, dangerous
places
Risk of electrical shock
Potentially hazardous bodily
fluids
Potentially hazardous or
cancer-causing agents or
chemicals
How much NOISE is experienced daily in the work environment of this job? Check the appropriate level below.
Very quiet.
Quiet.
Moderate noise (i.e., an office with typewriters, photocopiers and/or computer printers).
Loud noise. Please describe: ____________________________________________________________________________
Very loud noise. Please describe: ________________________________________________________________________
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Does this job require that WEIGHT is lifted or FORCE is exerted? If so, how much and how often? Check all applicable
responses below.
Activity
Never
(0%)
Rarely
(less than 15%)
Occasionally
(16% to 40%)
Frequently
(41% to 70%)
Regularly
(over 70%)
Specific Examples
Up to 1 pound
2-5 pounds
6-10 pounds
11-15 pounds
16-20 pounds
21-25 pounds
26-30 pounds
31-35 pounds
36-40 pounds
41-45 pounds
46-50 pounds
50-75 pounds
75-100 pounds
100+ pounds
Identify the level of attention that is usually required during a typical workday in order to accomplish the essential functions of
this position. Indicate only one response.
Normal attention.
Frequent attention (typical examples include paying bills, posting journal entries, etc.).
Concentrated attention.
Extremely demanding attention (typical examples include high-level managerial responsibilities.).
Describe specific examples of mental activities.
Please describe any other working conditions that have not been identified that are applicable to this position.
Employee: Please submit the completed Job Analysis Questionnaire to your Supervisor by
February 13, 2015
Page 13 Rev1 as of 11-Dec-2014
JOB ANALYSIS QUESTIONNAIRE – SUPERVISOR REVIEW
How well does the information the employee(s) provided on the Job Analysis Questionnaire describe his or her job? Note any
clarifications or additions you have below.
If possible, please identify the section of the JAQ that applies to each of your comments.
Examples:
Problem Solving – The problems encountered in the job are varied, not routine.
Work Environment – Employee works in general office conditions, not extreme cold or heat.
What number of years of related experience is required for this position? Please provide the number of years required to be qualified
to perform this position. (For example, 1 year or less, more than 1 year up to 3 years, more than 3 years up to 5 years, etc.)
What level of formal education is required for this position? Please provide the required degree and field, if appropriate.
Supervisor: Please submit the completed Job Analysis Questionnaire and Supervisor Review to:
Human Resources Department at Campus Box 015.
Supervisor Name and Title: ________________________________________________________________________________
Job Title Reviewed: _______________________________________________________________________________________
Employee(s) Reviewed: ____________________________________________________________________________________
Department: __________________________________________________________________________________________