Case 3:03-cv-00973-DJS
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PROPOSED JURY QUESTIONNAIRE 1. Name: Current Address: For how long? 2. A. Please indicate the level of education you have receive: [ ] Grade school or less [ ] Some college [ ] Some high school [ ] College graduate [ ] High school graduate [ ] Post graduate [ ] Technical/vocational school B. If you received any education beyond high school, please indicate your major course of study: 3. A. Current employer: B. Current position and job duties (describe briefly): C. How many employees do you supervise, if any? E. What aspect of your job do you like most? F. What aspect of your job do you like least? G. Is your workplace unionized? Yes and whether you are a member: No If yes, please indicate union, Age: Sex: Marital Status:
4. List prior occupations and approximate number of years (include military):
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5. Occupation of spouse, significant other, or of other adults (including your children) living in your household:
6. Have you or anyone close to you ever filed a lawsuit? Yes If yes, for what reason? In your opinion, was the lawsuit resolved satisfactorily? 7. Have you or anyone close to you ever been sued? Yes If yes, for what reason? In your opinion, was the lawsuit resolved satisfactorily? No
No
8. If you were injured, emotionally, physically, or financially, as a result of someone else=s wrongdoing or fault, would you consider bringing a lawsuit? Yes No Please explain:
9. Generally, do you think a person who believes he or she has been discriminated against or unfairly treated on the job should file lawsuits against his or her employer? Yes No Please explain:
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10. Generally, do you think there should be limitations on a person=s right to bring a lawsuit? Yes No Please explain:
11. Have you or anyone close to you ever felt unfairly treated by an employer? (i.e., layoff, discrimination, performance review, availability of benefits, medical leave, injury on the job, etc. - Experience need not result in a lawsuit or formal complaint): Yes No Please explain:
12. Do you have any views concerning the amount of money damages that can be awarded in a lawsuit, as compensation for injuries? Yes No Please explain:
13. Do you think that a person should be able to seek compensation for emotional harm caused by someone else=s wrongdoing? Yes No Please explain:
14. In general, what are the most important obligations an employee owes his/her employer?
15. In general, what are the most important obligations an employer owes his/her 3
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employee?
16. Do you have any personal, philosophical, moral, or religious reason that would make it difficult for you to sit on a jury and decide issues of liability and money damages in this case? Yes No Please explain:
17. Have you ever sat as a juror before? Yes No If yes, please indicate: [ ] Civil [ ] Criminal [ ] Grand Juror [ ] Federal Court [ ] State Court Type of case (e.g., murder, car crash, etc.) 18. What clubs or organizations do you belong to? 19. Name three people you admire most: 1. 2. 3. 20. Please name the magazines and newspapers you read most often:
21. Please indicate the primary source from where you get most of your news (include radio): 22. Have you or anyone close to you ever experienced gender discrimination from an 4
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employer, landlord/housing situation, or a commercial business (store/restaurant, etc.)? Yes No Please explain: Was there a complaint? Yes No What was the result?
23. At the present time, do you think women are treated equally to men in the workplace? Yes No Please explain:
24. To what degree, if at all, do you think gender discrimination is a problem in today=s workplace? Very serious Serious Somewhat Not Please explain:
25. To what degree, if at all, do you think claims of gender discrimination are exaggerated? Frequently Somewhat Infrequently No opinion Please explain:
26. Have you or anyone close to you ever been accused of gender discrimination? Yes No Please explain: 27. Have you ever followed any gender discrimination cases in the news? Yes 5 No
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Please indicate the case and feelings about outcome:
28. Generally, based on your impressions, do you think the discrimination laws are equally fair to men and women, or do you think they favor one gender over the other? Laws unfair to women Laws unfair to men Laws fair to both No opinion Please explain:
29. Do you think that men are experiencing more discrimination as a result of efforts to treat women fairly? Yes No Please explain:
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