SURVEY 
                                                                      INTRODUCTION
         SAMPLE SEXUAL                                                Please take a few moments to answer this 
         HARASSMENT SURVEY                                            anonymous survey on sexual harassment in 
                                                                      [INSERT COMPANY NAME]. Your participation 
                                                                      will help us to understand the nature of the 
                                                                      problem in our organisation. We appreciate 
                                                                      your honesty and assure you that your answers 
                                                                      shall remain anonymous.
                                                                      For the purposes of this survey, we organise 
                                                                      sexual harassment into three categories: 
                                                                          VERBAL/NON VERBAL-HARASSMENT
                                                                      When someone gives another person unwanted 
                                                                      sexual attention through verbal or written 
                                                                      comments or conversation, or through noises or 
                                                                      actions at a distance. 
         This is a sample survey to help you better                       PHYSICAL HARASSMENT
         understand the extent to which sexual 
         harassment is a problem within your                          When someone uses physical pressure or force 
         organisation.                                                to have sexual contact with another person 
                                                                      against their will, e.g. groping, massaging, 
                                                                      holding hands. 
             SOME SURVEY TIPS                                             RAPE
         •  Make this an anonymous survey to 
             encourage responses. Do not ask for names                The most severe form of physical harassment 
             or any information that could give a person’s  involving non-consensual penetration, no 
             identity away, such as job title.                        matter how slight, of the vagina or anus with 
         •  This template is designed for current                     any body part or object, or non-consensual oral 
             employees, but you could tweak it to                     penetration by a sex organ of another person.
             include past employees too.                               
         •  Do not just target women, send it out to                  We define ‘workplace’ as:
             everyone.                                                                                   e.g. in the office, 
                                                                      On-site spaces Off-site spaces     newsroom or on set
         •  Always define the terms you are using 
             so that there is no confusion about                                                         e.g. in the field doing 
             what constitutes ‘sexual harassment’ or                                                     research and interviews
             ‘workplace’. This is especially important if 
             you have not done any sensitisation training             Online spaces                      any digital platform 
             yet.                                                                                        that anyone involved in 
                                                                                                         creating media content 
         •  Use an online survey manager like                                                            uses to communicate 
             SurveyMonkey which can help you to                                                          with employees.
             analyse data.
                                                                                                         e.g. conferences, 
         •  Publish the results of the survey within your             Work-related events                business trips, training 
             organisation.                                                                               sessions 
          
         •  Repeat the survey every one to two years                  Social events                      organised by [INSERT 
             to. monitor progress.                                                                       NAME]
             PAGE 51                SEXUAL HARASSMENT IN THE MEDIA
          1      WHAT IS YOUR STATUS AT [INSERT COMPANY                          7      WHOM DID YOU REPORT THE INCIDENT(S) TO?
                 NAME]?
                                                                                             The police                  HR
                      Editorial (employed)        Non-editorial (employe)                    My direct manager           Another manager
                      Editorial (freelancer)      Non-editorial (freelancer)                 A colleague or friend       My trusted personal 
                      I prefer not to say                                                    at work                     network outside of work
                 Other (please specify):                                                     N/A I responded ‘No’ or ‘N/A’ to to Q6
                                                                                        Other (please specify):
          2      WHAT IS YOUR GENDER?
                                                                                 8      IF YOU DID NOT REPORT THE INCIDENT(S), 
                      Male                     Female                                   WHY NOT?
                      Other                                                                  Worried no-one              Was embarrassed/
                                                                                             would believe me            ashamed
          3      HAVE YOU EVER BEEN VERBALLY/NON-                                            Worried for my job          N/A I responded 'Yes' 
                 VERBALLY HARASSED WHILE WORKING AT                                          security if I reported      or 'N/A' to Q6
                 [INSERT COMPANY NAME] AND BY WHOM?                                          Didn't know that it 
                                                                                             was harassment
                           A superiorA      colleague   A non-employee                  Other (please specify):
                                                        (e.g. interviewee)
                 Yes                                                             9      WHAT CAN ORGANISATION X DO TO ELIMINATE 
                 No                                                                     SEXUAL HARASSMENT IN THE WORKPLACE?
                 Unsure
                                                                                             Adopt zero tolerance        Conduct sensitisation 
                                                                                             policy against sexual       training on what 
          4      HAVE YOU EVER BEEN PHYSICALLY HARASSED                                      harassment                  sexual harassment is
                 WHILE WORKING AT [INSERT COMPANY NAME]                                      Introduce complaints        Managers and 
                 AND BY WHOM?                                                                procedures for sexual       executives should lead 
                                                                                             harassment                  by example
                           A superiorA      colleague   A non-employee                       Create a stand alone        Train managers 
                                                        (e.g. interviewee)                   sexual harassment           on how to prevent 
                                                                                             policy                      and identify sexual 
                 Yes                                                                                                     harassment
                 No                                                                          Establish safe              Employ more women, 
                                                                                             channels to report          to increase gender 
                 Unsure                                                                      incidents of                balance
                                                                                             harassment such as 
                                                                                             anonymous tip line
                 HAVE YOU EVER BEEN RAPED WHILE WORKING                                      Create a lead person        Have an open 
          5      AT [INSERT COMPANY NAME] AND BY WHOM?                                       on sexual harassment        dialogue about sexual 
                                                                                             issues within               harassment
                                                                                             ORGANISATION X
                           A superiorA      colleague   A non-employee                  Other (please specify):
                                                        (e.g. interviewee)
                 Yes
                 No                                                             10 FURTHER INFORMATION AND COMMENTS  
                 Unsure                                                                 ARE WELCOME
          6      DID YOU REPORT THE INCIDENT(S)?
                      Yes                      No
                      N/A, I responded ‘No’ to Q3-5
               PAGE 52                    SEXUAL HARASSMENT IN THE MEDIA