OCCUPY YOUR WORKPLACE SURVEY
Answers marked with a * are required.
 
1. Please provide your contact information:
Name
Phone
Email
 
 
 
2. Can we contact you about our group's ongoing work?
*
 
 
 
3. What is your employment status?
*






      
 
 
 
4. If you are employed, what is your job title or job description?
*
 
 
 
5. Do you feel that you are treated fairly at your job?
*
 
 
 
6. Are you interested in organizing in your workplace to improve your wages, benefits, working conditions, or treatment on the job?
*
 
 
 
7. Do you have any other comments?
 
 
           
 

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