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First Name*
Last Name*
Cell Phone*
Email Address*
Member/Employee Number*
1. Would a 10% pay cut cause hardship for your family?
Yes
No
2. Would a 10% pay cut make it difficult to pay your mortgage or rent?
Yes
No
3. Would a 10% pay cut make it difficult to pay to any of your utilities?
Yes
No
4. Would a 10% pay cut make it difficult to afford your current means of transportation?
Yes
No
5. Would a 10% pay cut make it difficult to buy groceries?
Yes
No
6. Are you currently paying for child care?
Yes
No
7.Do you financially support a child in higher education?
Yes
No
8.Do you financially support a family member other than a child such as a parent
Yes
No
9.Have you ever experienced homelessness?
Yes
No
10.The union will be creating a furlough response committee at your worksite. Would you be interested in joining?
Yes
No
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SUBMIT SURVEY
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