Data Submission Form


Survey Job Title and Level (if applicable) ______________________________________________
Data Effective Date ____________________
 
Your Company's Position Title and Level  
Exempt or Non-Exempt  
Locations  
This Position Typically Reports to:  
Number of Incumbents  
 
Base Pay
Minimum
Average
Maximum
Hourly or Annual (circle one)      
 
Salary Grade Range or Progression
Minimum
Average
Maximum
Hourly or Annual (circle one)      
 
If progression is tied to time in job, please explain
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
 
 
Work Schedule
Fixed
Alternating
Flex Time
Other (please explain)
Mark all possibilities        
 
Shift Differential
No
Yes
If yes, please explain
Mark if eligible      
 
Incentive Pay
Target
Low
Average
High
Paid to incumbents for last year's performance        
 
Bonus
Hiring
Retention
Other (please explain)
Mark all possibilities      
If eligible, indicate size as % of base pay      
 
 
 
 
SOURCE: hrVillage.com
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