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https://take.surveys.ci/s/DD77E70000/22831
Submission: On November 02 via manual from US — Scanned from DE
Submission: On November 02 via manual from US — Scanned from DE
Form analysis 1 forms found in the DOM
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<div _ngcontent-ycx-c108="" gdcolumns="100%" gdrows="repeat(5, auto)" gdgap="20px" gdalignrows="center" class="ng-star-inserted"
style="display: grid; grid-template-columns: 100%; grid-template-rows: repeat(5, auto); gap: 20px; justify-content: center; justify-items: stretch;"><mat-card _ngcontent-ycx-c108=""
class="mat-card mat-focus-indicator instructions-card _mat-animation-noopable">
<h1 _ngcontent-ycx-c108="">Culture Index Survey</h1>
<div _ngcontent-ycx-c108="">
<p>We are asking you to complete the Culture Index(TM) Survey so we can see how it may apply to your work related needs as well as our company requirements. It also assists us in better employee management and development.</p>
<p>First and foremost, please be informed that Culture Index is:</p>
<ul>
<li>A survey, not a test. There is no passing or failing.</li>
<li>There is no such thing as a perfect result.</li>
<li>We only measure work related behaviors.</li>
<li>We do not measure intelligence.</li>
<li>We do not measure a person's learning curve.</li>
<li>We cannot determine race, gender or religion.</li>
<li>We cannot determine your age.</li>
<li>We cannot determine your ambition.</li>
<li>We do not measure anything abnormal or clinical.</li>
</ul>
<p>Take your time, read the instructions and complete the survey by yourself. It is important to complete the survey, once you have begun. The average person requires 8-10 minutes. If you can not set aside at least that much time right now,
then please close the screen and re-use the link to complete the survey when you have more time. We thank you in advance for your cooperation.</p>
</div><br _ngcontent-ycx-c108="">
<div _ngcontent-ycx-c108="">Please enter your information</div>
<h4 _ngcontent-ycx-c108="" class="red-text mt-2">* Required</h4>
</mat-card><!----><mat-card _ngcontent-ycx-c108="" class="mat-card mat-focus-indicator _mat-animation-noopable">
<h3 _ngcontent-ycx-c108="">Select Language</h3><mat-form-field _ngcontent-ycx-c108=""
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<div class="mat-form-field-wrapper ng-tns-c70-1">
<div class="mat-form-field-flex ng-tns-c70-1"><!----><!---->
<div class="mat-form-field-infix ng-tns-c70-1"><mat-select _ngcontent-ycx-c108="" role="combobox" aria-autocomplete="none" aria-haspopup="true" formcontrolname="languageId" autocomplete="language"
class="mat-select ng-tns-c86-2 ng-tns-c70-1 ng-untouched ng-pristine ng-valid ng-star-inserted" aria-labelledby="mat-form-field-label-1 mat-select-value-1" id="mat-select-0" tabindex="0" aria-expanded="false" aria-required="false"
aria-disabled="false" aria-invalid="false">
<div cdk-overlay-origin="" class="mat-select-trigger ng-tns-c86-2">
<div class="mat-select-value ng-tns-c86-2" id="mat-select-value-1"><!----><span class="mat-select-value-text ng-tns-c86-2 ng-star-inserted"><span class="mat-select-min-line ng-tns-c86-2 ng-star-inserted">English
(English)</span><!----><!----></span><!----></div>
<div class="mat-select-arrow-wrapper ng-tns-c86-2">
<div class="mat-select-arrow ng-tns-c86-2"></div>
</div>
</div><!---->
</mat-select><span class="mat-form-field-label-wrapper ng-tns-c70-1"><label class="mat-form-field-label ng-tns-c70-1 ng-star-inserted" id="mat-form-field-label-1" for="mat-select-0" aria-owns="mat-select-0"><!----><mat-label
_ngcontent-ycx-c108="" class="ng-tns-c70-1 ng-star-inserted">Please enter your information</mat-label><!----><!----></label><!----></span></div><!---->
</div>
<div class="mat-form-field-underline ng-tns-c70-1 ng-star-inserted"><span class="mat-form-field-ripple ng-tns-c70-1"></span></div><!---->
<div class="mat-form-field-subscript-wrapper ng-tns-c70-1"><!---->
<div class="mat-form-field-hint-wrapper ng-tns-c70-1 ng-trigger ng-trigger-transitionMessages ng-star-inserted" style="opacity: 1; transform: translateY(0%);"><!---->
<div class="mat-form-field-hint-spacer ng-tns-c70-1"></div>
</div><!---->
</div>
</div>
</mat-form-field>
</mat-card><mat-card _ngcontent-ycx-c108="" class="mat-card mat-focus-indicator _mat-animation-noopable">
<h3 _ngcontent-ycx-c108=""> First Name <span _ngcontent-ycx-c108="" class="red-text inner-span">*</span></h3><mat-form-field _ngcontent-ycx-c108=""
class="mat-form-field ng-tns-c70-3 mat-primary mat-form-field-type-mat-input mat-form-field-appearance-legacy mat-form-field-can-float mat-form-field-has-label mat-form-field-hide-placeholder ng-untouched ng-pristine ng-invalid _mat-animation-noopable ng-star-inserted">
<div class="mat-form-field-wrapper ng-tns-c70-3">
<div class="mat-form-field-flex ng-tns-c70-3"><!----><!---->
<div class="mat-form-field-infix ng-tns-c70-3"><input _ngcontent-ycx-c108="" matinput="" formcontrolname="firstName" autocomplete="given-name"
class="mat-input-element mat-form-field-autofill-control ng-tns-c70-3 ng-untouched ng-pristine ng-invalid cdk-text-field-autofill-monitored" id="mat-input-0" aria-invalid="false" aria-required="false"><span
class="mat-form-field-label-wrapper ng-tns-c70-3"><label class="mat-form-field-label ng-tns-c70-3 mat-empty mat-form-field-empty ng-star-inserted" id="mat-form-field-label-3" for="mat-input-0" aria-owns="mat-input-0"><!----><mat-label
_ngcontent-ycx-c108="" class="ng-tns-c70-3 ng-star-inserted">Please enter your information</mat-label><!----><!----></label><!----></span></div><!---->
</div>
<div class="mat-form-field-underline ng-tns-c70-3 ng-star-inserted"><span class="mat-form-field-ripple ng-tns-c70-3"></span></div><!---->
<div class="mat-form-field-subscript-wrapper ng-tns-c70-3"><!---->
<div class="mat-form-field-hint-wrapper ng-tns-c70-3 ng-trigger ng-trigger-transitionMessages ng-star-inserted" style="opacity: 1; transform: translateY(0%);"><!---->
<div class="mat-form-field-hint-spacer ng-tns-c70-3"></div>
</div><!---->
</div>
</div>
</mat-form-field>
</mat-card><mat-card _ngcontent-ycx-c108="" class="mat-card mat-focus-indicator _mat-animation-noopable">
<h3 _ngcontent-ycx-c108=""> Last Name <span _ngcontent-ycx-c108="" class="red-text inner-span">*</span></h3><mat-form-field _ngcontent-ycx-c108=""
class="mat-form-field ng-tns-c70-4 mat-primary mat-form-field-type-mat-input mat-form-field-appearance-legacy mat-form-field-can-float mat-form-field-has-label mat-form-field-hide-placeholder ng-untouched ng-pristine ng-invalid _mat-animation-noopable ng-star-inserted">
<div class="mat-form-field-wrapper ng-tns-c70-4">
<div class="mat-form-field-flex ng-tns-c70-4"><!----><!---->
<div class="mat-form-field-infix ng-tns-c70-4"><input _ngcontent-ycx-c108="" matinput="" formcontrolname="lastName" autocomplete="family-name"
class="mat-input-element mat-form-field-autofill-control ng-tns-c70-4 ng-untouched ng-pristine ng-invalid cdk-text-field-autofill-monitored" id="mat-input-1" aria-invalid="false" aria-required="false"><span
class="mat-form-field-label-wrapper ng-tns-c70-4"><label class="mat-form-field-label ng-tns-c70-4 mat-empty mat-form-field-empty ng-star-inserted" id="mat-form-field-label-5" for="mat-input-1" aria-owns="mat-input-1"><!----><mat-label
_ngcontent-ycx-c108="" class="ng-tns-c70-4 ng-star-inserted">Please enter your information</mat-label><!----><!----></label><!----></span></div><!---->
</div>
<div class="mat-form-field-underline ng-tns-c70-4 ng-star-inserted"><span class="mat-form-field-ripple ng-tns-c70-4"></span></div><!---->
<div class="mat-form-field-subscript-wrapper ng-tns-c70-4"><!---->
<div class="mat-form-field-hint-wrapper ng-tns-c70-4 ng-trigger ng-trigger-transitionMessages ng-star-inserted" style="opacity: 1; transform: translateY(0%);"><!---->
<div class="mat-form-field-hint-spacer ng-tns-c70-4"></div>
</div><!---->
</div>
</div>
</mat-form-field>
</mat-card><mat-card _ngcontent-ycx-c108="" class="mat-card mat-focus-indicator _mat-animation-noopable">
<h3 _ngcontent-ycx-c108=""> E-mail <span _ngcontent-ycx-c108="" class="red-text inner-span">*</span></h3><mat-form-field _ngcontent-ycx-c108=""
class="mat-form-field wide-form-field ng-tns-c70-5 mat-primary mat-form-field-type-mat-input mat-form-field-appearance-legacy mat-form-field-can-float mat-form-field-has-label mat-form-field-hide-placeholder ng-untouched ng-pristine ng-invalid _mat-animation-noopable ng-star-inserted">
<div class="mat-form-field-wrapper ng-tns-c70-5">
<div class="mat-form-field-flex ng-tns-c70-5"><!----><!---->
<div class="mat-form-field-infix ng-tns-c70-5"><input _ngcontent-ycx-c108="" matinput="" formcontrolname="email" autocomplete="email"
class="mat-input-element mat-form-field-autofill-control ng-tns-c70-5 ng-untouched ng-pristine ng-invalid cdk-text-field-autofill-monitored" id="mat-input-2" aria-invalid="false" aria-required="false"><span
class="mat-form-field-label-wrapper ng-tns-c70-5"><label class="mat-form-field-label ng-tns-c70-5 mat-empty mat-form-field-empty ng-star-inserted" id="mat-form-field-label-7" for="mat-input-2" aria-owns="mat-input-2"><!----><mat-label
_ngcontent-ycx-c108="" class="ng-tns-c70-5 ng-star-inserted">Please enter your information</mat-label><!----><!----></label><!----></span></div><!---->
</div>
<div class="mat-form-field-underline ng-tns-c70-5 ng-star-inserted"><span class="mat-form-field-ripple ng-tns-c70-5"></span></div><!---->
<div class="mat-form-field-subscript-wrapper ng-tns-c70-5"><!---->
<div class="mat-form-field-hint-wrapper ng-tns-c70-5 ng-trigger ng-trigger-transitionMessages ng-star-inserted" style="opacity: 1; transform: translateY(0%);"><!---->
<div class="mat-form-field-hint-spacer ng-tns-c70-5"></div>
</div><!---->
</div>
</div>
</mat-form-field>
</mat-card><!----><mat-card _ngcontent-ycx-c108="" class="mat-card mat-focus-indicator _mat-animation-noopable">
<h3 _ngcontent-ycx-c108=""> Birthday <span _ngcontent-ycx-c108="" class="red-text inner-span">*</span></h3><mat-form-field _ngcontent-ycx-c108=""
class="mat-form-field mr-4 ng-tns-c70-6 mat-primary mat-form-field-type-mat-select mat-form-field-appearance-legacy mat-form-field-can-float mat-form-field-has-label mat-form-field-hide-placeholder ng-untouched ng-pristine ng-invalid _mat-animation-noopable ng-star-inserted">
<div class="mat-form-field-wrapper ng-tns-c70-6">
<div class="mat-form-field-flex ng-tns-c70-6"><!----><!---->
<div class="mat-form-field-infix ng-tns-c70-6"><mat-select _ngcontent-ycx-c108="" role="combobox" aria-autocomplete="none" aria-haspopup="true" formcontrolname="bMonth" autocomplete="bday-month"
class="mat-select ng-tns-c86-7 ng-tns-c70-6 mat-select-empty ng-untouched ng-pristine ng-invalid ng-star-inserted" aria-labelledby="mat-form-field-label-9 mat-select-value-3" id="mat-select-2" tabindex="0" aria-expanded="false"
aria-required="false" aria-disabled="false" aria-invalid="false">
<div cdk-overlay-origin="" class="mat-select-trigger ng-tns-c86-7">
<div class="mat-select-value ng-tns-c86-7" id="mat-select-value-3"><span class="mat-select-placeholder mat-select-min-line ng-tns-c86-7 ng-star-inserted"></span><!----><!----></div>
<div class="mat-select-arrow-wrapper ng-tns-c86-7">
<div class="mat-select-arrow ng-tns-c86-7"></div>
</div>
</div><!---->
</mat-select><span class="mat-form-field-label-wrapper ng-tns-c70-6"><label class="mat-form-field-label ng-tns-c70-6 mat-empty mat-form-field-empty ng-star-inserted" id="mat-form-field-label-9" for="mat-select-2"
aria-owns="mat-select-2"><!----><mat-label _ngcontent-ycx-c108="" class="ng-tns-c70-6 ng-star-inserted">Please enter your information</mat-label><!----><!----></label><!----></span></div><!---->
</div>
<div class="mat-form-field-underline ng-tns-c70-6 ng-star-inserted"><span class="mat-form-field-ripple ng-tns-c70-6"></span></div><!---->
<div class="mat-form-field-subscript-wrapper ng-tns-c70-6"><!---->
<div class="mat-form-field-hint-wrapper ng-tns-c70-6 ng-trigger ng-trigger-transitionMessages ng-star-inserted" style="opacity: 1; transform: translateY(0%);"><!---->
<div class="mat-form-field-hint-spacer ng-tns-c70-6"></div>
</div><!---->
</div>
</div>
</mat-form-field><mat-form-field _ngcontent-ycx-c108=""
class="mat-form-field ng-tns-c70-8 mat-primary mat-form-field-type-mat-select mat-form-field-appearance-legacy mat-form-field-can-float mat-form-field-has-label mat-form-field-hide-placeholder ng-untouched ng-pristine ng-invalid _mat-animation-noopable ng-star-inserted">
<div class="mat-form-field-wrapper ng-tns-c70-8">
<div class="mat-form-field-flex ng-tns-c70-8"><!----><!---->
<div class="mat-form-field-infix ng-tns-c70-8"><mat-select _ngcontent-ycx-c108="" role="combobox" aria-autocomplete="none" aria-haspopup="true" formcontrolname="bDay" autocomplete="bday-day"
class="mat-select ng-tns-c86-9 ng-tns-c70-8 mat-select-empty ng-untouched ng-pristine ng-invalid ng-star-inserted" aria-labelledby="mat-form-field-label-11 mat-select-value-5" id="mat-select-4" tabindex="0" aria-expanded="false"
aria-required="false" aria-disabled="false" aria-invalid="false">
<div cdk-overlay-origin="" class="mat-select-trigger ng-tns-c86-9">
<div class="mat-select-value ng-tns-c86-9" id="mat-select-value-5"><span class="mat-select-placeholder mat-select-min-line ng-tns-c86-9 ng-star-inserted"></span><!----><!----></div>
<div class="mat-select-arrow-wrapper ng-tns-c86-9">
<div class="mat-select-arrow ng-tns-c86-9"></div>
</div>
</div><!---->
</mat-select><span class="mat-form-field-label-wrapper ng-tns-c70-8"><label class="mat-form-field-label ng-tns-c70-8 mat-empty mat-form-field-empty ng-star-inserted" id="mat-form-field-label-11" for="mat-select-4"
aria-owns="mat-select-4"><!----><mat-label _ngcontent-ycx-c108="" class="ng-tns-c70-8 ng-star-inserted">Please enter your information</mat-label><!----><!----></label><!----></span></div><!---->
</div>
<div class="mat-form-field-underline ng-tns-c70-8 ng-star-inserted"><span class="mat-form-field-ripple ng-tns-c70-8"></span></div><!---->
<div class="mat-form-field-subscript-wrapper ng-tns-c70-8"><!---->
<div class="mat-form-field-hint-wrapper ng-tns-c70-8 ng-trigger ng-trigger-transitionMessages ng-star-inserted" style="opacity: 1; transform: translateY(0%);"><!---->
<div class="mat-form-field-hint-spacer ng-tns-c70-8"></div>
</div><!---->
</div>
</div>
</mat-form-field>
</mat-card><mat-card _ngcontent-ycx-c108="" class="mat-card mat-focus-indicator _mat-animation-noopable ng-star-inserted">
<h3 _ngcontent-ycx-c108="">Job Title</h3><mat-form-field _ngcontent-ycx-c108=""
class="mat-form-field ng-tns-c70-10 mat-primary mat-form-field-type-mat-input mat-form-field-appearance-legacy mat-form-field-can-float mat-form-field-has-label mat-form-field-hide-placeholder ng-untouched ng-pristine ng-valid _mat-animation-noopable ng-star-inserted">
<div class="mat-form-field-wrapper ng-tns-c70-10">
<div class="mat-form-field-flex ng-tns-c70-10"><!----><!---->
<div class="mat-form-field-infix ng-tns-c70-10"><input _ngcontent-ycx-c108="" matinput="" formcontrolname="employeeTitle" autocomplete="organization-title"
class="mat-input-element mat-form-field-autofill-control ng-tns-c70-10 ng-untouched ng-pristine ng-valid cdk-text-field-autofill-monitored" id="mat-input-3" aria-invalid="false" aria-required="false"><span
class="mat-form-field-label-wrapper ng-tns-c70-10"><label class="mat-form-field-label ng-tns-c70-10 mat-empty mat-form-field-empty ng-star-inserted" id="mat-form-field-label-13" for="mat-input-3"
aria-owns="mat-input-3"><!----><mat-label _ngcontent-ycx-c108="" class="ng-tns-c70-10 ng-star-inserted">Please input current job title...</mat-label><!----><!----></label><!----></span></div><!---->
</div>
<div class="mat-form-field-underline ng-tns-c70-10 ng-star-inserted"><span class="mat-form-field-ripple ng-tns-c70-10"></span></div><!---->
<div class="mat-form-field-subscript-wrapper ng-tns-c70-10"><!---->
<div class="mat-form-field-hint-wrapper ng-tns-c70-10 ng-trigger ng-trigger-transitionMessages ng-star-inserted" style="opacity: 1; transform: translateY(0%);"><!---->
<div class="mat-form-field-hint-spacer ng-tns-c70-10"></div>
</div><!---->
</div>
</div>
</mat-form-field>
</mat-card><!----></div><!----><!---->
</form>Text Content
CULTURE INDEX-MARK CONNELLY Survey powered by Culture Index™ CULTURE INDEX SURVEY We are asking you to complete the Culture Index(TM) Survey so we can see how it may apply to your work related needs as well as our company requirements. It also assists us in better employee management and development. First and foremost, please be informed that Culture Index is: * A survey, not a test. There is no passing or failing. * There is no such thing as a perfect result. * We only measure work related behaviors. * We do not measure intelligence. * We do not measure a person's learning curve. * We cannot determine race, gender or religion. * We cannot determine your age. * We cannot determine your ambition. * We do not measure anything abnormal or clinical. Take your time, read the instructions and complete the survey by yourself. It is important to complete the survey, once you have begun. The average person requires 8-10 minutes. If you can not set aside at least that much time right now, then please close the screen and re-use the link to complete the survey when you have more time. We thank you in advance for your cooperation. Please enter your information * REQUIRED SELECT LANGUAGE English (English) Please enter your information FIRST NAME * Please enter your information LAST NAME * Please enter your information E-MAIL * Please enter your information BIRTHDAY * Please enter your information Please enter your information JOB TITLE Please input current job title... Next Page Terms & Conditions and Privacy Policy